Kyle John Pankonin, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC3858 Issued in MN

Practice address

214 Main St
Lamberton, MN 56152-1377

Phone

(507) 752-7650

Fax

(507) 752-7635

NPI assigned

Jun 24, 2005

Last updated

Jul 12, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Red Rock Chiropractic Center LLCGroup PAC ID 7719402221, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Red Rock Chiropractic Center LLC

  • Chiropractor
  • Lamberton, MN
  • NPI 1215441027
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1366448276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 MAIN ST",
            "address_2": "PO BOX 517",
            "city": "LAMBERTON",
            "state": "MN",
            "postal_code": "561521377",
            "telephone_number": "507-752-7650",
            "fax_number": "507-752-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 MAIN ST",
            "city": "LAMBERTON",
            "state": "MN",
            "postal_code": "561521377",
            "telephone_number": "507-752-7650",
            "fax_number": "507-752-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKONIN",
        "first_name": "KYLE",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "DC3858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "15F52RE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SERVICES MANAGEMEN",
            "identifier": "411508205",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colton Cogdill, DC
• Stephen Harold Danielson, DDS
• Harvest Counseling Services, LLC
• Jami Lee Holman
• Lamberton Operations LLC (Valley View manor healthcare center)
• James David Rains III
• Red Rock Central Isd 2884
• Red Rock Chiropractic Center LLC
• Redwood Lamberton Holdings LLC (Lamberton Restorative Care Center)
• Valleyview Manor Nursing Home

• Chiropractor in Lamberton, MN
• Providers in Lamberton, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.