Kade Keck, DC

Key facts

NPI

1346838232

Entity type

Individual (NPI type 1)

Primary specialty

Chiropractor 111N00000X

License

CHIA-2096 (ID)

Practice address

528 N State St
Shelley, ID 83274-1154

Phone

(208) 357-0333

NPI assigned

Jan 6, 2021

Sex

Male

Sole proprietor

No

Organizations & group practices 3

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.

• Lifetime Wellness Chiropractic PLLC Chiropractor · Shelley, ID · NPI 1962734889
  Medicare reassignment Care Compare group NPD CHIROPRACTOR · ID
• Ellis Chiropractic Inc Chiropractor · Blackfoot, ID · NPI 1043406705
  Care Compare group
• Shelley Chiropractic, P.a. Primary Care Clinic/Center · Shelley, ID · NPI 1811167109
  NPD (past)

Medicare Care Compare profile

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ellis Chiropractic Inc (2 clinicians)
Lifetime Wellness Chiropractic PLLC (3 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in ID

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 6, 2021.

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1346838232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 N STATE ST",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "832741154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 N STATE ST",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "832741154",
            "telephone_number": "208-357-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "KADE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelley, ID

• Michael Hernandez
• Amanda Medrano Johnson, LPC
• Klarice Ann Johnson, LCSW
• Joint School District 60
• Jordan Daniel Keck, DC
• Kerner Counseling and Consultation Group
• Madison Knowles, MS, LMHC, LPC, LCPC
• Kaja Madison Korenke, IS
• Viktoriya Lichtenberg
• Lifetime Wellness Chiropractic PLLC

All providers in Shelley, ID · Chiropractor in Idaho