Blake Allen Klessig, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5134 Issued in NC

Practice address

6580 Old Monroe Rd Ste a
Indian Trail, NC 28079-5362

Phone

(704) 225-8686

NPI assigned

Jan 10, 2020

Last updated

Mar 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Integrative Chiropractic and Natural Medicine

  • Chiropractor
  • Indian Trail, NC
  • NPI 1942560818
  Medicare reassignment NPD
• Integrative Chiropractic of Ballantyne PLLC

  • Chiropractor
  • Charlotte, NC
  • NPI 1306678552
  Medicare reassignment NPD
• Marco Chiropractic, PLLC

  • Preferred Provider Organization
  • Charlotte, NC
  • NPI 1093104044
  NPD

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1316587082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6580 OLD MONROE RD STE A",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795362",
            "telephone_number": "704-225-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6580 OLD MONROE RD STE A",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795362",
            "telephone_number": "704-225-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLESSIG",
        "first_name": "BLAKE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-10",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madhavi Keerthivarman
• Timothy Patrick Kennard, MD
• Andrew Bird Kindel, MD
• Valerie King
• Brianna Klaus, DPT
• Rachel J Knox, MS.,CCC-SLP
• Leonardo Koerich, DDS
• Faith Kreoger
• Varsha Kulkarni, MD
• L Carter Enterprises LLC (VitalPath Wellness Group)

• Chiropractor in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.