Individual provider Active NPI

Nicholas James Kimel, DC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1407890254
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7485 Issued in AZ
Practice address
13615 N 35TH Ave
Ste 1
Phoenix, AZ 85029
Phone
(602) 993-1722
Fax
(602) 866-0219
NPI assigned
Jun 15, 2006
Last updated
Nov 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7485 AZ Primary

Addresses

Primary practice location

13615 N 35TH Ave
Ste 1
Phoenix, AZ 85029

Mailing address

13615 N 35TH Ave
Ste 1
Phoenix, AZ 85029
Phone (602) 993-1722

Other identifiers 1

IdentifierTypeStateIssuer
AZ0242280OtherAZBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040819001371 AZ Practitioner - Chiropractic 8325012065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Kimel Chiropractic Center PCGroup PAC ID 7416933130, 4 clinicians

Practice addresses (Care Compare)

17250 N 43Rd Ave
Suite 3
Glendale, AZ 85308-4024
Phone (602) 993-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7485AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kimel Chiropractic Center PC Chiropractor CurrentSince Jun 18, 2004 Accepting new patients

Locations

17250 N 43rd Ave
Ste 3
Glendale, AZ 85308
Phone (602) 993-1722

13615 N 35th Ave
Ste 1
Phoenix, AZ 85029
Phone (602) 993-1722

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, 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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1407890254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13615 N 35TH AVE",
            "address_2": "STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85029",
            "telephone_number": "602-993-1722",
            "fax_number": "602-866-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13615 N 35TH AVE",
            "address_2": "STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85029",
            "telephone_number": "602-993-1722",
            "fax_number": "602-866-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMEL",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0242280",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.