Organization Active NPI

Life Medical Center of Lecanto,Inc

Doing business as Kinnard Chiropractic

  • Chiropractor
  • Inverness, FL
National Provider Identifier
1386613180
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6693 Issued in FL
Legal business name
LIFE MEDICAL CENTER OF LECANTO,INC
Doing business as
Kinnard Chiropractic
Practice address
2611 Highway 44 W
Inverness, FL 34453-3725
Phone
(352) 726-0554
Fax
(352) 726-3885
NPI assigned
Mar 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Authorized official

Name
Jeffery S Kinnard, DCNPI 1548282965
Title
Owner
Phone
(352) 726-0554

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH6693 FL Primary

Addresses

Primary practice location

2611 Highway 44 W
Inverness, FL 34453-3725

Mailing address

2611 Highway 44 W
Inverness, FL 34453-3725
Phone (352) 726-0554

Other identifiers 1

IdentifierTypeStateIssuer
38954OtherBLUE CROSS & BLUE SHIELD

Other names 1

  • Kinnard Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000546 FL Part B Supplier - Clinic/Group Practice 5294632485 Receives reassigned benefits from 3 practitioners
Practice locations: Inverness, FL

National Provider Directory

National Provider Directory

Locations

255 SE 7th Ave
Crystal River, FL 34429
Phone (352) 563-5055

2611 Highway 44 W
Inverness, FL 34453
Phone (352) 563-5055

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1386613180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 HIGHWAY 44 W",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344533725",
            "telephone_number": "352-726-0554",
            "fax_number": "352-726-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 HIGHWAY 44 W",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344533725",
            "telephone_number": "352-726-0554",
            "fax_number": "352-726-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE MEDICAL CENTER OF LECANTO,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "KINNARD",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-726-0554",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "38954",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kinnard Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inverness, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.