Kyunghwan An, D.C
Individual provider Active NPI Chiropractor · Grandview, MO
NPI 1285037689 · NPPES record last updated Jul 15, 2019
Key facts
- NPI
- 1285037689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2013013772 (MO)
- Practice address
- 12121 Blue Ridge Blvd
Suite O
Grandview, MO 64030-1723 - Phone
- (816) 217-0020
- Fax
- (816) 469-5325
- NPI assigned
- Sep 30, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Kansas City, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12121 Blue Ridge Ext
Suite a
Grandview, MO 64030-1103
Phone (816) 217-0020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190320000944 | MO | Practitioner - Chiropractic | 4587904081 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2013013772 | MO | Yes |
| Acupuncturist | 171100000X | 2013013772 | MO |
Addresses
Primary practice location
12121 Blue Ridge Blvd
Suite O
Grandview, MO 64030-1723
Mailing address
12121 Blue Ridge Ext Ste a
Grandview, MO 64030-1103
Phone (816) 217-0020
Other providers in Grandview, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.