Kenneth Patrick Myers, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC29455 Issued in CA

Practice address

9033 Baseline Rd
Suite Q
Rancho Cucamonga, CA 91730-1255

Phone

(909) 945-8721

Fax

(909) 980-9301

NPI assigned

Nov 17, 2005

Last updated

Nov 19, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Los Angeles College of Chiropractic, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kenneth Myers Chiropractic Corporation

  dba San Antonio Pain Relief Center

  • Chiropractor
  • Rancho Cucamonga, CA
  • NPI 1467751966
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1457333122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9033 BASELINE RD",
            "address_2": "SUITE Q",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301255",
            "telephone_number": "909-945-8721",
            "fax_number": "909-980-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9033 BASELINE RD",
            "address_2": "SUITE Q",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301255",
            "telephone_number": "909-945-8721",
            "fax_number": "909-980-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KENNETH",
        "middle_name": "PATRICK",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.