Active NPI
Kevin James Munksgard, D.C.
- Chiropractor
- Mesa, AZ
National Provider Identifier
1265462915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC 29480
- Practice address
- 753 S Alma School Rd Ste 3
Mesa, AZ 85210-1086 - Phone
- (480) 827-2197
- NPI assigned
- Jul 4, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC 29480 | CA | Primary |
Addresses
Primary practice location
753 S Alma School Rd Ste 3
Mesa, AZ 85210-1086
Mailing address
164 N 74TH St Apt 2086
Mesa, AZ 85207-8321
Phone (480) 854-4423
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7681336 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29480 | CA | MD | Mental Health Counselor |
| DC 29480 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1265462915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 N 74TH ST APT 2086",
"city": "MESA",
"state": "AZ",
"postal_code": "852078321",
"telephone_number": "480-854-4423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "753 S ALMA SCHOOL RD STE 3",
"city": "MESA",
"state": "AZ",
"postal_code": "852101086",
"telephone_number": "480-827-2197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNKSGARD",
"first_name": "KEVIN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC 29480",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7681336",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.