Organization Active NPI

KB Chiropractic Center, Inc.

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1396132692
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012782 Issued in IL
Legal business name
KB CHIROPRACTIC CENTER, INC.
Practice address
431 Phelps Ave Ste 601
Rockford, IL 61108-3101
Phone
(815) 229-5568
Fax
(815) 860-1674
NPI assigned
Apr 24, 2015
Last updated
Jun 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Authorized official

Name
Dr. Kelly Bond, D.C.NPI 1316220387
Title
President
Phone
(815) 229-5568

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 038012782 IL Primary

Addresses

Primary practice location

431 Phelps Ave Ste 601
Rockford, IL 61108-3101

Mailing address

431 Phelps Ave Ste 601
Rockford, IL 61108-3101
Phone (815) 229-5568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150527002251 IL Part B Supplier - Clinic/Group Practice 2365762697 Receives reassigned benefits from 1 practitioner
Practice locations: Rockford, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1429833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1396132692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 PHELPS AVE STE 601",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083101",
            "telephone_number": "815-229-5568",
            "fax_number": "815-860-1674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 PHELPS AVE STE 601",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083101",
            "telephone_number": "815-229-5568",
            "fax_number": "815-860-1674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KB CHIROPRACTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-24",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "BOND",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-229-5568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.