Individual provider Active NPI

Joseph Richard Kanan, D.C

  • Chiropractor
  • Tullahoma, TN
National Provider Identifier
1437108727
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2217 Issued in TN
Practice address
1940 N Jackson St
Suite 110
Tullahoma, TN 37388-8254
Phone
(931) 393-2401
Fax
(931) 393-2402
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2217 TN Primary

Addresses

Primary practice location

1940 N Jackson St
Suite 110
Tullahoma, TN 37388-8254

Mailing address

1940 N Jackson St
Suite 110
Tullahoma, TN 37388-8254
Phone (931) 393-2401

Other identifiers 1

IdentifierTypeStateIssuer
1515111MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090611000220 TN Practitioner - Chiropractic 9931276011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tullahoma Integrated Health PCGroup PAC ID 5991152027, 2 clinicians

Practice addresses (Care Compare)

1940 N Jackson
Suite 110
Tullahoma, TN 37388-8255

1940 N Jackson St
Suite 110
Tullahoma, TN 37388-8255
Phone (931) 393-2401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tullahoma Integrated Health, P.C. Chiropractor CurrentSince Mar 1, 2024 Accepting new patients

Locations

1940 N Jackson St
Ste 110
Tullahoma, TN 37388
Phone (931) 393-2401

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1437108727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 N JACKSON ST",
            "address_2": "SUITE 110",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373888254",
            "telephone_number": "931-393-2401",
            "fax_number": "931-393-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 N JACKSON ST",
            "address_2": "SUITE 110",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373888254",
            "telephone_number": "931-393-2401",
            "fax_number": "931-393-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAN",
        "first_name": "JOSEPH",
        "middle_name": "RICHARD",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515111",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.