Individual provider Active NPI

Seth A Kouba, DC

  • Chiropractor
  • Lees Summit, MO
National Provider Identifier
1356469019
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2004017439 Issued in MO
Practice address
323 SE Wilson St
Lees Summit, MO 64063-2715
Phone
(816) 246-8990
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2004017439 MO Primary

Addresses

Primary practice location

323 SE Wilson St
Lees Summit, MO 64063-2715

Mailing address

1807 Allendale Dr
Greenwood, MO 64034-9445
Phone (816) 728-6793

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041113000173 MO Practitioner - Chiropractic 4486618063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

816 NW Park LN
Suite G
Lees Summit, MO 64063-1881

816 NW Park LN G
Spine Center
Lees Summit, MO 64063-1881
Phone (816) 246-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004017439MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Family Chiropractic Chiropractor CurrentSince Dec 12, 2007 Accepting new patients

Locations

312 NE State Route 291
Lees Summit, MO 64086
Phone (816) 246-4325

816 NW Park Ln
Ste G
Lees Summit, MO 64063
Phone (816) 246-4325

317 SW Market St
Lees Summit, MO 64063
Phone (816) 246-4325

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1356469019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 ALLENDALE DR",
            "city": "GREENWOOD",
            "state": "MO",
            "postal_code": "640349445",
            "telephone_number": "816-728-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 SE WILSON ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632715",
            "telephone_number": "816-246-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUBA",
        "first_name": "SETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2004017439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.