Individual provider Active NPI

Kennedy Jean Volkart, DC

  • Chiropractor
  • California, MO
National Provider Identifier
1437764487
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2020029922 Issued in MO
Practice address
1116 S Oak St
California, MO 65018-1400
Phone
(573) 796-3777
NPI assigned
Sep 15, 2020
Last updated
Sep 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2020029922 MO Primary

Addresses

Primary practice location

1116 S Oak St
California, MO 65018-1400

Mailing address

1116 S Oak St
California, MO 65018-1400
Phone (573) 796-3777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221000882 MO Practitioner - Chiropractic 6002228897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Juul Spine and Sport Chiropractic LLCGroup PAC ID 7012326564, 3 clinicians

Practice addresses (Care Compare)

1116 S Oak St
California, MO 65018-1400
Phone (573) 796-3777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020029922MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Juul Spine & Sport Chiropractic, LLC. CurrentSince May 3, 2021 Accepting new patients

Locations

1116 S Oak St
California, MO 65018
Phone (573) 796-3777

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": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1437764487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 S OAK ST",
            "city": "CALIFORNIA",
            "state": "MO",
            "postal_code": "650181400",
            "telephone_number": "573-796-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 S OAK ST",
            "city": "CALIFORNIA",
            "state": "MO",
            "postal_code": "650181400",
            "telephone_number": "573-796-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLKART",
        "first_name": "KENNEDY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2020029922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.