Individual provider Active NPI

Kyle Yates, DC

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1417545674
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4618 Issued in SC
Practice address
16 Mills Ave Ste 3
Greenville, SC 29605-4065
Phone
(864) 881-2242
NPI assigned
Jan 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4618 SC Primary

Addresses

Primary practice location

16 Mills Ave Ste 3
Greenville, SC 29605-4065

Mailing address

16 Mills Ave Ste 3
Greenville, SC 29605-4065
Phone (864) 881-2242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210316000377 SC Practitioner - Chiropractic 5496161564
I20231216000219 TX Practitioner - Chiropractic 5496161564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synapse Human Performance Centers, Inc.Group PAC ID 0749610681, 5 clinicians

Practice addresses (Care Compare)

3800 Gaylord Pkwy
Suite 795
Frisco, TX 75034-1102
Phone (214) 902-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4618SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Fox Health LLC CurrentSince Nov 8, 2023 Accepting new patients

Locations

3800 Gaylord Pkwy
Ste 795
Frisco, TX 75034
Phone (214) 902-3400

3800 Gaylord Pkwy
Frisco, TX 75034
Phone (214) 235-2810

Interoperability endpoints

  • Direct secure messaging: kyle.yates.1@23964.direct.athenahealth.com

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": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1417545674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MILLS AVE STE 3",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054065",
            "telephone_number": "864-881-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MILLS AVE STE 3",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054065",
            "telephone_number": "864-881-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.