Individual provider Active NPI

Kowin K Casey, DC, PT

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1396250718
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2017039451 Issued in MO
Practice address
1815 Grand Blvd
Kansas City, MO 64108-1815
Phone
(913) 424-2410
Fax
(913) 491-7997
NPI assigned
Dec 7, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05978 KS
Rehabilitation Chiropractor 111NR0400X 01-05978 KS
Sports Physician Chiropractor 111NS0005X 2017039451 MO
Chiropractor 111N00000X 2017039451 MO Primary

Addresses

Primary practice location

1815 Grand Blvd
Kansas City, MO 64108-1815

Mailing address

1815 Grand Blvd
Kansas City, MO 64108-1815
Phone (913) 424-2410

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL 9134914994 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
01-05978KSMDChiropractor
2017039451MOMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyle Chiropractic and Wellness LLC Past Accepting new patients

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": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1396250718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 GRAND BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081815",
            "telephone_number": "913-424-2410",
            "fax_number": "913-491-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 GRAND BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081815",
            "telephone_number": "913-424-2410",
            "fax_number": "913-491-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "KOWIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DC, PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-07",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05978",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "KS",
            "license": "01-05978",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MO",
            "license": "2017039451",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017039451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "9134914994",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1815 Grand Blvd",
            "city": "Kansas City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641081815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.