Individual provider Active NPI

Kenneth S.J. Murkowski, D.C

  • Chiropractor
  • Jackson, MI
National Provider Identifier
1477525244
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301002595 Issued in MI
Practice address
645 Saint Clair Ave
Jackson, MI 49202-2024
Phone
(517) 784-9123
Fax
(517) 784-9150
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301002595 MI Primary

Addresses

Primary practice location

645 Saint Clair Ave
Jackson, MI 49202-2024

Mailing address

645 Saint Clair Ave
Jackson, MI 49202-2024
Phone (517) 784-9123

Other identifiers 2

IdentifierTypeStateIssuer
950C850180OtherMIBLUE CROSS PIN
1057984-14MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1477525244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 SAINT CLAIR AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022024",
            "telephone_number": "517-784-9123",
            "fax_number": "517-784-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 SAINT CLAIR AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022024",
            "telephone_number": "517-784-9123",
            "fax_number": "517-784-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURKOWSKI",
        "first_name": "KENNETH",
        "middle_name": "S.J.",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301002595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "950C850180",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1057984-14",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.