Individual provider Active NPI

Kelsey Stallbaumer, D.C.

  • Chiropractor
  • Hiawatha, KS
National Provider Identifier
1376926212
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05738 Issued in KS
Practice address
206 S 1St St
Hiawatha, KS 66434-2618
Phone
(785) 742-7164
Fax
(816) 436-7501
NPI assigned
Jul 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2015022046 MO
Chiropractor 111N00000X 01-05738 KS Primary

Addresses

Primary practice location

206 S 1St St
Hiawatha, KS 66434-2618

Mailing address

206 S 1St St
Hiawatha, KS 66434-2618
Phone (785) 742-7164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160715001362 KS Practitioner - Chiropractic 6103130240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stallbaumer Family Chiropractic LLCGroup PAC ID 0244522951, 2 clinicians

Practice addresses (Care Compare)

206 S 1St St
Hiawatha, KS 66434-2618
Phone (785) 742-7164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stallbaumer Family Chiropractic LLC Chiropractor CurrentSince Jun 6, 2016 Accepting new patients

Locations

206 S 1st St
Hiawatha, KS 66434
Phone (785) 742-7164

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": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1376926212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S 1ST ST",
            "city": "HIAWATHA",
            "state": "KS",
            "postal_code": "664342618",
            "telephone_number": "785-742-7164",
            "fax_number": "816-436-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S 1ST ST",
            "city": "HIAWATHA",
            "state": "KS",
            "postal_code": "664342618",
            "telephone_number": "785-742-7164",
            "fax_number": "816-436-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLBAUMER",
        "first_name": "KELSEY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2015022046",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.