Individual provider Active NPI

Jamie L Kirgis, D.C.

  • Chiropractor
  • Columbia City, IN
National Provider Identifier
1487795399
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001982A Issued in IN
Practice address
695 N Opportunity Dr
Columbia City, IN 46725-1041
Phone
(260) 244-3665
Fax
(260) 248-4496
NPI assigned
Feb 12, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 08001982A IN Primary

Addresses

Primary practice location

695 N Opportunity Dr
Columbia City, IN 46725-1041

Mailing address

1325 E Greenbriar Dr
Columbia City, IN 46725-8622
Phone (260) 248-2194

Other identifiers 12

IdentifierTypeStateIssuer
P00152266OtherINPALMETTO GBA M
200432250MedicaidIN
2919344OtherINALLIED BENEFITS
7437258OtherINAETNA
P00152266OtherINRR MEDICARE
000000336368OtherININ BLUE SHIELD ANTHEM
214620BOtherINAPWU HEALTH PLAN
214620BOtherINHUMANA CLAIMS
214620BOtherINMEDICARE COMPLETE ESSNTL
200432250OtherINMANAGED HEALTH SERVICE IN
214620BOtherINSECURE HORIZONS DIRECT
214620BOtherINUNICARE PFFS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040428001602 IN Practitioner - Chiropractic 8022004274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whitley Chiropractic and Wellness CenterGroup PAC ID 3072509223, 2 clinicians

Practice addresses (Care Compare)

695 N Opportunity Dr
Columbia City, IN 46725-1041
Phone (260) 244-3665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001982AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whitley Chiropractic & Wellness Center Chiropractor CurrentSince Jan 1, 2004 Accepting new patients
Health Centered of Scottsburg, Inc Chiropractor Past Accepting new patients
Health Centered Chiropractic Chiropractor Past Accepting new patients

Locations

695 N Opportunity Dr
Columbia City, IN 46725
Phone (260) 244-3665

6242 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 244-3665

Organizations & group practices 3

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487795399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E GREENBRIAR DR",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467258622",
            "telephone_number": "260-248-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 N OPPORTUNITY DR",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467251041",
            "telephone_number": "260-244-3665",
            "fax_number": "260-248-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRGIS",
        "first_name": "JAMIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001982A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA M",
            "identifier": "P00152266",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200432250",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIED BENEFITS",
            "identifier": "2919344",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7437258",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00152266",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN BLUE SHIELD ANTHEM",
            "identifier": "000000336368",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APWU HEALTH PLAN",
            "identifier": "214620B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA CLAIMS",
            "identifier": "214620B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE COMPLETE ESSNTL",
            "identifier": "214620B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH SERVICE IN",
            "identifier": "200432250",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURE HORIZONS DIRECT",
            "identifier": "214620B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE PFFS",
            "identifier": "214620B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.