Individual provider Active NPI

Kathryn Marie Flaherty, D. C.

  • Chiropractor
  • Ottawa, IL
National Provider Identifier
1457415051
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
042618790 Issued in IL
Practice address
643 W Main St
Ottawa, IL 61350-2717
Phone
(815) 431-1350
Fax
(815) 431-1360
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 042618790 IL Primary

Addresses

Primary practice location

643 W Main St
Ottawa, IL 61350-2717

Mailing address

1001 Clinton St
Ottawa, IL 61350-2039
Phone (815) 431-1350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060428000284 IL Practitioner - Chiropractic 3375553951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ottawa ChiropracticGroup PAC ID 2961638960, 3 clinicians

Practice addresses (Care Compare)

1001 Clinton St
Ottawa, IL 61350-2039
Phone (815) 431-8303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042618790ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ottawa Chiropractic Chiropractor CurrentSince Oct 1, 2013 Accepting new patients

Locations

1001 Clinton St
Ottawa, IL 61350
Phone (815) 431-8303

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1457415051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CLINTON ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502039",
            "telephone_number": "815-431-1350",
            "fax_number": "815-431-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 W MAIN ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502717",
            "telephone_number": "815-431-1350",
            "fax_number": "815-431-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAHERTY",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "042618790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.