Individual provider Active NPI

Kimberly Sanborn, D.C.

  • Chiropractor
  • Bonita Springs, FL
National Provider Identifier
1336672344
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12151 Issued in FL
Practice address
9138 Bonita Beach Rd SE
Bonita Springs, FL 34135-4291
Phone
(239) 908-9762
NPI assigned
Apr 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12151 FL Primary

Addresses

Primary practice location

9138 Bonita Beach Rd SE
Bonita Springs, FL 34135-4291

Mailing address

9138 Bonita Beach Rd SE
Bonita Springs, FL 34135-4291
Phone (239) 908-9762

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170613002128 FL Practitioner - Chiropractic 1456629526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulfside Chiropractic Health CenterGroup PAC ID 3274801345, 4 clinicians

Practice addresses (Care Compare)

9138 Bonita Beach Rd SE
Bonita Springs, FL 34135-4291
Phone (239) 908-9762

9250 College Pkwy
Suite 4
Fort Myers, FL 33919-4847
Phone (239) 689-8495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12151FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gulfside Chiropractic Health Center Chiropractor CurrentSince Apr 14, 2017 Accepting new patients
Atlas Wellness Group LLC Chiropractor CurrentSince Mar 1, 2021 Accepting new patients

Locations

9138 Bonita Beach Rd SE
Bonita Springs, FL 34135
Phone (239) 908-9762

9250 College Pkwy
Ste 4
Fort Myers, FL 33919
Phone (239) 689-8495

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": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1336672344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9138 BONITA BEACH RD SE",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354291",
            "telephone_number": "239-908-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9138 BONITA BEACH RD SE",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354291",
            "telephone_number": "239-908-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANBORN",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.