Individual provider Active NPI

Kathryn Penniman Alexander, DC CHIROPRACTOR

  • Chiropractor
  • Annapolis, MD
National Provider Identifier
1306911409
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
502083 Issued in MD
Practice address
108 Old Solomons Island Rd
BLDG 2 Ste a
Annapolis, MD 21401
Phone
(410) 266-1638
Fax
(410) 266-6205
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 502083 MD Primary

Addresses

Primary practice location

108 Old Solomons Island Rd
BLDG 2 Ste a
Annapolis, MD 21401

Mailing address

PO Box 188
Edgewater, MD 21037
Phone (410) 266-1638

Other identifiers 2

IdentifierTypeStateIssuer
G3390001OtherMDBLUE CROSS BLUE SHIELD
M683OtherMDBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406001259 MD Practitioner - Chiropractic 1557354438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1610 W St
Suite 205
Annapolis, MD 21401-4054
Phone (410) 570-0717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
502083MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Attunement Chiropractic LLC Chiropractor CurrentSince Jan 24, 2018 Accepting new patients

Locations

1610 West St
Ste 205
Annapolis, MD 21401
Phone (410) 570-0717

203 Ridgely Ave
Annapolis, MD 21401
Phone (301) 261-1053

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306911409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "21037",
            "telephone_number": "410-266-1638",
            "fax_number": "410-266-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OLD SOLOMONS ISLAND RD",
            "address_2": "BLDG 2 STE A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-266-1638",
            "fax_number": "410-266-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "KATHRYN",
        "middle_name": "PENNIMAN",
        "credential": "DC CHIROPRACTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "502083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "G3390001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M683",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.