Individual provider Active NPI

Kristina Adelheid Irvin, DC

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1477687176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
19164 Issued in CA
Practice address
2034 Forest Ave Ste 2a
San Jose, CA 95128-4809
Phone
(408) 938-3588
Fax
(408) 938-3590
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 19164 CA Primary

Addresses

Primary practice location

2034 Forest Ave Ste 2a
San Jose, CA 95128-4809

Mailing address

2034 Forest Ave Ste 2a
San Jose, CA 95128-4809
Phone (408) 938-3588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091019000462 CA Practitioner - Chiropractic 1951448257 Practice locations: Los Gatos, CA; San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

875 Saratoga Ave
San Jose, CA 95129-2332
Phone (408) 938-3588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19164CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
De Salvo Chiropractic Corp Chiropractor Past Accepting new patients
Upright Chiropractic Chiropractor PastSince Feb 18, 2024 Accepting new patients

Organizations & group practices 2

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477687176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 FOREST AVE STE 2A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284809",
            "telephone_number": "408-938-3588",
            "fax_number": "408-938-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 FOREST AVE STE 2A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284809",
            "telephone_number": "408-938-3588",
            "fax_number": "408-938-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "KRISTINA",
        "middle_name": "ADELHEID",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "19164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.