Kenn E Iverson DC P C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

733 Issued in ND

Legal business name

KENN E IVERSON DC P C

Practice address

312 2ND Ave SW Ste 101
Jamestown, ND 58401-4177

Phone

(701) 252-2424

Fax

(701) 252-3205

NPI assigned

Oct 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tammy Zuck

Title

Office Manager

Phone

(701) 252-2424

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenn E Iverson, DC PC

  • Chiropractor
  • Jamestown, ND
  • NPI 1275625030

  ND

  Medicare reassignment
• Casey Andrews, PT, DPT

  • Physical Therapist
  • Jamestown, ND
  • NPI 1700255296
  NPD (past)
• Kyle Blumenshine, DPT

  • Orthopedic Physical Therapist
  • Jamestown, ND
  • NPI 1801349550
  NPD (past)
• Zachary James Neva, PT

  • Physical Therapist
  • Jamestown, ND
  • NPI 1346730728
  NPD (past)
• Madysen Geneva Rehovsky, PT, DPT

  • Physical Therapist
  • West Fargo, ND
  • NPI 1841920543
  NPD (past)
• Mika Sigurjoen Thorlakson, D.C.

  • Chiropractor
  • Jamestown, ND
  • NPI 1740331875
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1265629240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 2ND AVE SW STE 101",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584014177",
            "telephone_number": "701-252-2424",
            "fax_number": "701-252-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 2ND AVE SW STE 101",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584014177",
            "telephone_number": "701-252-2424",
            "fax_number": "701-252-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENN E IVERSON DC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "ZUCK",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "701-252-2424"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13530",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6577-001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kama Residential Services LLC
• Jill Catherine Kang, DPM
• Stanley Karzon Sr., DD
• Henry Kates Jr., LAC
• Patrick Kellam
• Janelle Lacey Kertzman, FNP-C
• Ian Keyes
• Nyamah Keymah II, CNA
• Holly Kiehl, MS RD, LRD
• Brittany Kilgore, PT, DPT

• All providers in Jamestown, ND
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.