Individual provider Active NPI

Kenneth J Beck, D.C.

  • Chiropractor
  • Hamburg, NY
National Provider Identifier
1447374079
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007389-1 Issued in NY
Practice address
5864 Camp Rd
Hamburg, NY 14075-4424
Phone
(716) 649-6944
Fax
(716) 649-6407
NPI assigned
Mar 19, 2007
Last updated
Dec 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 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 X007389-1 NY Primary

Addresses

Primary practice location

5864 Camp Rd
Hamburg, NY 14075-4424

Mailing address

5864 Camp Rd
Hamburg, NY 14075-4424
Phone (716) 649-6944

Other identifiers 6

IdentifierTypeStateIssuer
5802463OtherNYGHI
668940OtherNYACN
929795OtherNYMPN
00020332101OtherNYUNIVERA
002231421OtherNYBLUE CROSS
161452055-01OtherNYPRISM HEALTH NETWORK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120306000156 NY Practitioner - Chiropractic 3173782547 Practice locations: Hamburg, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5864 Camp Rd
Hamburg, NY 14075-4424
Phone (716) 649-6944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X007389-1NYMDChiropractor
007389NYMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1447374079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5864 CAMP RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754424",
            "telephone_number": "716-649-6944",
            "fax_number": "716-649-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5864 CAMP RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754424",
            "telephone_number": "716-649-6944",
            "fax_number": "716-649-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007389-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5802463",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "668940",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPN",
            "identifier": "929795",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020332101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "002231421",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRISM HEALTH NETWORK",
            "identifier": "161452055-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.