Optimal Spine Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2979 Issued in TN

Legal business name

OPTIMAL SPINE CHIROPRACTIC PLLC

Practice address

55 Mouse Creek Rd NW
Cleveland, TN 37312-4840

Phone

(423) 716-6025

Fax

(423) 641-0858

NPI assigned

Nov 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Kyle D Koser, DCNPI 1376086660

Title

Doctor of Chiropractic

Phone

(423) 716-6025

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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

• Kyle D Koser, DC

  • Chiropractor
  • Cleveland, TN
  • NPI 1376086660
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1467995209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MOUSE CREEK RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124840",
            "telephone_number": "423-716-6025",
            "fax_number": "423-641-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MOUSE CREEK RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124840",
            "telephone_number": "423-716-6025",
            "fax_number": "423-641-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL SPINE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "KOSER",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "423-716-6025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.