Individual provider Active NPI

Kevin David Drumbore, DC

  • Chiropractor
  • Chatham, NJ
National Provider Identifier
1366555906
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00434500 Issued in NJ
Practice address
552 Main St
Chatham, NJ 07928-2120
Phone
(973) 635-3100
Fax
(973) 635-3109
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00434500 NJ Primary

Addresses

Primary practice location

552 Main St
Chatham, NJ 07928-2120

Mailing address

552 Main St
Chatham, NJ 07928-2120
Phone (973) 635-3100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070112000176 NJ Practitioner - Chiropractic 4981604089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19 Ctr St
Chatham, NJ 07928-2599

552 Main St
Chatham, NJ 07928-2120
Phone (973) 635-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center Street Chiropractic LLC Chiropractor CurrentSince Aug 16, 2005 Accepting new patients

Locations

19 Center St
Chatham, NJ 07928
Phone (973) 635-3100

552 Main St
Chatham, NJ 07928
Phone (973) 635-3100

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1366555906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 MAIN ST",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282120",
            "telephone_number": "973-635-3100",
            "fax_number": "973-635-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 MAIN ST",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282120",
            "telephone_number": "973-635-3100",
            "fax_number": "973-635-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUMBORE",
        "first_name": "KEVIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00434500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.