Active NPI
Kirk A Abernathy, D.C.
- Chiropractor
- Fayette, IA
National Provider Identifier
1316044654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- A5607
- Practice address
- 139 South Main Street
Fayette, IA 52142-0578 - Phone
- (563) 425-3341
- Fax
- (563) 425-3342
- NPI assigned
- Sep 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 | A5607 | IA | Primary |
Addresses
Primary practice location
139 South Main Street
Fayette, IA 52142-0578
Mailing address
139 S. Main
Fayette, IA 52142-0578
Phone (563) 425-3341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0104646 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1991
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
139 S Main St PO Box
Suite 578
Fayette, IA 52142-0578
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A5607 | IA | MD | Chiropractor |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Fayette Chiropractic Clinic
- Primary Care Clinic/Center
- Fayette, IA
- NPI 1508052903
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316044654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 S. MAIN",
"city": "FAYETTE",
"state": "IA",
"postal_code": "521420578",
"telephone_number": "563-425-3341",
"fax_number": "563-425-3342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 SOUTH MAIN STREET",
"city": "FAYETTE",
"state": "IA",
"postal_code": "521420578",
"telephone_number": "563-425-3341",
"fax_number": "563-425-3342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABERNATHY",
"first_name": "KIRK",
"middle_name": "A",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "A5607",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0104646",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayette, IA
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.