Individual provider Active NPI

Thomas Edward Forbach, D.C.

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1447314422
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-03367 Issued in KS
Practice address
14201 Metcalf Ave
Overland Park, KS 66223-3367
Phone
(913) 814-9494
Fax
(913) 814-7050
NPI assigned
Dec 21, 2006
Last updated
Jun 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-03367 KS Primary
Chiropractor 111N00000X 5222 CO
Chiropractor 111N00000X 004001 MO

Addresses

Primary practice location

14201 Metcalf Ave
Overland Park, KS 66223-3367

Mailing address

14201 Metcalf Ave
Overland Park, KS 66223-3367
Phone (913) 814-9494

Other identifiers 1

IdentifierTypeStateIssuer
06154029OtherMOBLUECROSSBLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507000470 KS Practitioner - Chiropractic 3779571732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lionsgate Chiropractic Center for Wellness PAGroup PAC ID 4789713314, 2 clinicians

Practice addresses (Care Compare)

14201 Metcalf Ave
Overland Park, KS 66223-3367
Phone (913) 814-9494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03367KSMDPsychologist
5222COMDChiropractor
004001MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lionsgate Chiropractic Center for Wellness PA Chiropractor CurrentSince May 12, 2010 Accepting new patients

Locations

14201 Metcalf Ave
Overland Park, KS 66223
Phone (913) 648-8600

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1447314422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233367",
            "telephone_number": "913-814-9494",
            "fax_number": "913-814-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233367",
            "telephone_number": "913-814-9494",
            "fax_number": "913-814-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBACH",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-03367",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5222",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "004001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "06154029",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.