Individual provider Active NPI

Jarrod Steven Kerkhoff, DC

  • Chiropractor
  • Loves Park, IL
National Provider Identifier
1346259553
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0038-8334 Issued in IL
Practice address
421 River LN
Loves Park, IL 61111-5040
Phone
(815) 633-7272
Fax
(815) 633-7274
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0038-8334 IL Primary

Addresses

Primary practice location

421 River LN
Loves Park, IL 61111-5040

Mailing address

421 River LN
Loves Park, IL 61111-5040
Phone (815) 633-7272

Other identifiers 1

IdentifierTypeStateIssuer
0038-8334MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120111000612 IL Practitioner - Chiropractic 4981708195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loves Park Chiropractic Clinic S CGroup PAC ID 6901900117, 2 clinicians

Practice addresses (Care Compare)

421 River LN
Loves Park, IL 61111-5040
Phone (815) 633-7272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0038-8334ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Loves Park Chiropractic Clinic S C Chiropractor CurrentSince Jun 8, 1999 Accepting new patients

Locations

5946 N 2nd St
Loves Park, IL 61111
Phone (815) 633-7272

421 River Ln
Loves Park, IL 61111
Phone (815) 395-6016

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1346259553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 RIVER LN",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611115040",
            "telephone_number": "815-633-7272",
            "fax_number": "815-633-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 RIVER LN",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611115040",
            "telephone_number": "815-633-7272",
            "fax_number": "815-633-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERKHOFF",
        "first_name": "JARROD",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "0038-8334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038-8334",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.