Active NPI
Mackenzie Kohnke, DC
- Chiropractor
- Keokuk, IA
National Provider Identifier
1437813631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 110717
- Practice address
- 612 Main St
Keokuk, IA 52632-5450 - Phone
- (319) 670-9718
- NPI assigned
- Oct 25, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 110717 | IA | Primary |
Addresses
Primary practice location
612 Main St
Keokuk, IA 52632-5450
Mailing address
612 Main St
Keokuk, IA 52632-5450
Phone (319) 670-9718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211105001486 | IA | Practitioner - Chiropractic | 4880083237 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
612 Main St
Keokuk, IA 52632-5450
Phone (319) 524-3339
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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": "1635120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1437813631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 MAIN ST",
"city": "KEOKUK",
"state": "IA",
"postal_code": "526325450",
"telephone_number": "319-670-9718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 MAIN ST",
"city": "KEOKUK",
"state": "IA",
"postal_code": "526325450",
"telephone_number": "319-670-9718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHNKE",
"first_name": "MACKENZIE",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-25",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "110717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keokuk, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.