Individual provider Active NPI

Gerald E. Klein, D.C.

  • Chiropractor
  • Fulton, MS
National Provider Identifier
1376567941
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0990 Issued in MS
Practice address
101 Wheeler Dr Suite B
Fulton, MS 38843
Phone
(662) 862-2071
Fax
(662) 862-2071
NPI assigned
Jul 27, 2006
Last updated
May 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 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 0990 MS Primary

Addresses

Primary practice location

101 Wheeler Dr Suite B
Fulton, MS 38843

Mailing address

PO Box 824
Fulton, MS 38843-0824
Phone (662) 862-2071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060920000511 MS Practitioner - Chiropractic 9335100593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

418 Hospital Rd
Fulton, MS 38843-6017
Phone (662) 862-2071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0990MSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Discover Chiropractic PA Chiropractor CurrentSince May 1, 2021 Accepting new patients
Life Chiropractic Center PA Chiropractor PastSince Jul 10, 2004 Accepting new patients

Locations

418 Hospital Rd
Fulton, MS 38843
Phone (601) 862-2131

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1376567941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "388430824",
            "telephone_number": "662-862-2071",
            "fax_number": "662-862-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WHEELER DR SUITE B",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "38843",
            "telephone_number": "662-862-2071",
            "fax_number": "662-862-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "GERALD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "0990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.