Active NPI
Mackenzie Alexander Kolt, DC
- Chiropractor
- West Los Angeles, CA
National Provider Identifier
1427514009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 34360
- Practice address
- 12217 Santa Monica Blvd Ste 208
West Los Angeles, CA 90025-2589 - Phone
- (310) 447-3540
- NPI assigned
- Feb 19, 2019
- Last updated
- Feb 19, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 34360 | CA | Primary |
| Rehabilitation Chiropractor | 111NR0400X | 34360 | CA |
Addresses
Primary practice location
12217 Santa Monica Blvd Ste 208
West Los Angeles, CA 90025-2589
Mailing address
515 Stephen St
Morden, MANITOBA R6M1E7
CA
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34360 | CA | MD | Rehabilitation Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kolt Chiropractic Wellness Center Inc | Chiropractor | Past | Accepting new patients |
| Cooper Wellness Chiropractic Center Inc | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- Los Angeles, CA
- NPI 1376000927
-
dba Cooper Chiropractic Wellness Center inc
- Chiropractor
- Los Angeles, CA
- NPI 1619168929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1427514009",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "515 STEPHEN ST",
"city": "MORDEN",
"state": "MANITOBA",
"postal_code": "R6M1E7"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12217 SANTA MONICA BLVD STE 208",
"city": "WEST LOS ANGELES",
"state": "CA",
"postal_code": "900252589",
"telephone_number": "310-447-3540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLT",
"first_name": "MACKENZIE",
"middle_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-19",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "34360",
"primary": true
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "34360",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.