NPIMap

Organization Active NPI

Kenneth Myers Chiropractic Corporation

Doing business as San Antonio Pain Relief Center

  • Chiropractor
  • Rancho Cucamonga, CA
National Provider Identifier
1467751966
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0294550 Issued in CA
Legal business name
KENNETH MYERS CHIROPRACTIC CORPORATION
Doing business as
San Antonio Pain Relief Center
Practice address
9033 Baseline Rd
Q
Rancho Cucamonga, CA 91730-1255
Phone
(909) 945-8721
Fax
(909) 980-9301
NPI assigned
Mar 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Authorized official

Name
Dr. Kenneth Myers, D.C.NPI 1457333122
Title
Owner
Phone
(909) 945-8721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC0294550 CA Primary

Addresses

Primary practice location

9033 Baseline Rd
Q
Rancho Cucamonga, CA 91730-1255

Mailing address

9033 Baseline Rd
Q
Rancho Cucamonga, CA 91730-1255
Phone (909) 945-8721

Other names 1

  • SAN ANTONIO PAIN RELIEF CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110330000783 CA Part B Supplier - Clinic/Group Practice 5092998963 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

9033 Base Line Rd
Ste Q
Rch Cucamonga, CA 91730
Phone (909) 945-8721

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300838400000",
    "number": "1467751966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9033 BASELINE RD",
            "address_2": "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": "Q",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301255",
            "telephone_number": "909-945-8721",
            "fax_number": "909-980-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH MYERS CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2011-03-23",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-945-8721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC0294550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN ANTONIO PAIN RELIEF CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.