Individual provider Active NPI

Kenneth Walker Register, D.C.

  • Chiropractor
  • Valdosta, GA
National Provider Identifier
1346309242
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO 06055 Issued in GA
Practice address
409 Northside Dr
Valdosta, GA 31602-1801
Phone
(229) 242-3042
Fax
(229) 242-7035
NPI assigned
Dec 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO 06055 GA Primary

Addresses

Primary practice location

409 Northside Dr
Valdosta, GA 31602-1801

Mailing address

409 Northside Dr
Valdosta, GA 31602-1801
Phone (229) 242-3042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111206000087 GA Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 3072616978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mink Chiropractic Center, LLCGroup PAC ID 2365545266, 3 clinicians

Practice addresses (Care Compare)

409 Northside Dr
Valdosta, GA 31602-1801
Phone (229) 242-3042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO 06055GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mink Chiropractic Center, LLC Chiropractor CurrentSince Aug 1, 2000 Accepting new patients

Locations

409 Northside Dr
Valdosta, GA 31602
Phone (229) 242-3042

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346309242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 NORTHSIDE DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021801",
            "telephone_number": "229-242-3042",
            "fax_number": "229-242-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 NORTHSIDE DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021801",
            "telephone_number": "229-242-3042",
            "fax_number": "229-242-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGISTER",
        "first_name": "KENNETH",
        "middle_name": "WALKER",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO 06055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.