Individual provider Active NPI

Kyle Cardel, D.C.

  • Chiropractor
  • Cheyenne, WY
National Provider Identifier
1477921104
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
754 Issued in WY
Practice address
1122 Logan Ave
Cheyenne, WY 82001-5216
Phone
(712) 281-0202
NPI assigned
Sep 11, 2015
Last updated
Jun 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 754 WY Primary

Addresses

Primary practice location

1122 Logan Ave
Cheyenne, WY 82001-5216

Mailing address

1122 Logan Ave
Cheyenne, WY 82001-5216
Phone (712) 281-0202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161007001043 WY Practitioner - Chiropractic 8628366689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Chiropractic Sports and Wellness PCGroup PAC ID 0547448003, 2 clinicians

Practice addresses (Care Compare)

1023 E Lincolnway
Cheyenne, WY 82001-4843
Phone (307) 635-7727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
754WYMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Sports & Wellness PC Chiropractor CurrentSince Dec 18, 2023 Accepting new patients
Bodybalance Chiropractor CurrentSince Mar 12, 2024 Accepting new patients

Locations

1023 E Lincolnway
Cheyenne, WY 82001
Phone (307) 635-7727

1600 Converse Ave
Cheyenne, WY 82001
Phone (307) 514-5964

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1477921104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 LOGAN AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015216",
            "telephone_number": "712-281-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 LOGAN AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015216",
            "telephone_number": "712-281-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDEL",
        "first_name": "KYLE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-11",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.