Active NPI
Kenneth P. Soulsby, D.C.
- Chiropractor
- Deming, NM
National Provider Identifier
1417048679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 839
- Practice address
- 909 South Gold Ave
Deming, NM 88030-4754 - Phone
- (575) 546-7331
- Fax
- (575) 546-5380
- NPI assigned
- Sep 27, 2006
- Last updated
- Oct 20, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 839 | NM | Primary |
| Chiropractor | 111N00000X | 3800 | AZ |
Addresses
Primary practice location
909 South Gold Ave
Deming, NM 88030-4754
Mailing address
909 South Gold Ave
Deming, NM 88030-4754
Phone (575) 546-7331
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3800 | AZ | MD | Occupational Therapist |
| 839 | NM | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287532800000",
"number": "1417048679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 SOUTH GOLD AVE",
"city": "DEMING",
"state": "NM",
"postal_code": "880304754",
"telephone_number": "575-546-7331",
"fax_number": "575-546-5380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 SOUTH GOLD AVE",
"city": "DEMING",
"state": "NM",
"postal_code": "880304754",
"telephone_number": "575-546-7331",
"fax_number": "575-546-5380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOULSBY",
"first_name": "KENNETH",
"middle_name": "P.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2010-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NM",
"license": "839",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "3800",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deming, NM
- Jenifer Smyer, FNP-C, AGACNP-BC
- Nikki Dion Smyer
- Sandra Snyder
- Clara Maria Solis
- Jaime Solis, M.D.
- Southern New Mexico Orthodontics LLC
- Southwest Bone and Joint Institute PC
- Southwest Pediatric and Family Care, LLC (Southwest Pediatric Care, LLC)
- Southwest Regional Education Cooperative
- Southwest Therapeutics LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.