Individual provider Active NPI

John Alan Klitzke, D.C.

  • Chiropractor
  • Apache Junction, AZ
National Provider Identifier
1447327101
Registry record updated Feb 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7010 Issued in AZ
Practice address
189 W Apache TRL # A101
Apache Junction, AZ 85220-3435
Phone
(480) 671-6710
Fax
(480) 671-6713
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7010 AZ Primary

Addresses

Primary practice location

189 W Apache TRL # A101
Apache Junction, AZ 85220-3435

Mailing address

189 W Apache TRL
Ste A101
Apache JCT, AZ 85120-3435
Phone (480) 671-6710

Other identifiers 1

IdentifierTypeStateIssuer
AZ0936120OtherAZBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041025000128 AZ Practitioner - Chiropractic 4981665932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

189 W Apache TRL
Suite 101
Apache JCT, AZ 85120-3493
Phone (480) 671-6710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7010AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Klitzke Family Chiropractic & Rehab, LLC Chiropractor CurrentSince Nov 1, 2004 Accepting new patients

Locations

189 W Apache Trl
#A101
Apache Junction, AZ 85120
Phone (480) 671-6710

189 W Apache Trl
Ste 101
Apache Junction, AZ 85120
Phone (480) 671-6710

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488067200000",
    "number": "1447327101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 W APACHE TRL",
            "address_2": "STE A101",
            "city": "APACHE JCT",
            "state": "AZ",
            "postal_code": "851203435",
            "telephone_number": "480-671-6710",
            "fax_number": "480-671-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 W APACHE TRL # A101",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852203435",
            "telephone_number": "480-671-6710",
            "fax_number": "480-671-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLITZKE",
        "first_name": "JOHN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2017-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0936120",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2017; 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.