Organization Active NPI

Kaizen Chiropractic LLC

  • Sports Physician Chiropractor
  • Bethesda, MD
National Provider Identifier
1356997530
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
KAIZEN CHIROPRACTIC LLC
Practice address
4641 Montgomery Ave Ste 404
Bethesda, MD 20814-3431
Phone
(240) 670-0081
NPI assigned
Aug 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Authorized official

Name
Jennifer L Davis, DCNPI 1962723304
Title
Director of Sport Medicine
Phone
(240) 670-0081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X Primary
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204C00000X
Sports Medicine (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PS0010X
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X
Sports Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083S0010X
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X

Addresses

Primary practice location

4641 Montgomery Ave Ste 404
Bethesda, MD 20814-3431

Mailing address

4641 Montgomery Ave Ste 404
Bethesda, MD 20814-3431
Phone (240) 670-0081

Other identifiers 1

IdentifierTypeStateIssuer
1962723304OtherMDNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL DrChrono Direct

National Provider Directory

National Provider Directory

Locations

4641 Montgomery Ave
Ste 404
Bethesda, MD 20814
Phone (240) 670-0081

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1356997530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 MONTGOMERY AVE STE 404",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143431",
            "telephone_number": "240-670-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 MONTGOMERY AVE STE 404",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143431",
            "telephone_number": "240-670-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIZEN CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF SPORT MEDICINE",
        "authorized_official_telephone_number": "240-670-0081",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962723304",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "DrChrono",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Digital",
            "address_1": "4641 Montgomery Ave Ste 404",
            "city": "Bethesda",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208143431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.