Individual provider Active NPI

Steven L. Kellenberger, DC

  • Chiropractor
  • Fort Worth, TX
National Provider Identifier
1336192087
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12753 Issued in TX
Practice address
9500 Ray White Rd Ste 200
Fort Worth, TX 76244
Phone
(833) 333-4375
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038006969 IL
Chiropractor 111N00000X 12753 TX Primary

Addresses

Primary practice location

9500 Ray White Rd Ste 200
Fort Worth, TX 76244

Mailing address

9500 Ray White Rd Ste 200
Fort Worth, TX 76244-9105
Phone (833) 333-4375

Other practice location 1

425 N Liberty St
Elgin, IL 60120-4268
Phone (847) 742-5070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12753TXMDAddiction (Substance Use Disorder) Counselor
038006969ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Neuroscience & Spine Institute, LLC Chiropractor Past Accepting new patients
Kellenberger Chiropractic Clinic SC Chiropractor PastSince Feb 15, 2008 Accepting new patients

Organizations & group practices 2

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1336192087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 RAY WHITE RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762449105",
            "telephone_number": "833-333-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 RAY WHITE RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "833-333-4375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 N Liberty St",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601204268",
            "country_code": "US",
            "telephone_number": "847-742-5070",
            "fax_number": "847-742-2131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLENBERGER",
        "first_name": "STEVEN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006969",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.