Individual provider Active NPI

Kevin D Anderson, DC

  • Chiropractor
  • Terre Haute, IN
National Provider Identifier
1487952933
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002805A Issued in IN
Practice address
1549 Fort Harrison Rd
Terre Haute, IN 47804-1332
Phone
(812) 460-4700
Fax
(812) 460-4701
NPI assigned
Mar 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002805A IN Primary
Chiropractor 111N00000X 5281 KY

Addresses

Primary practice location

1549 Fort Harrison Rd
Terre Haute, IN 47804-1332

Mailing address

1549 Fort Harrison Rd
Terre Haute, IN 47804-1332
Phone (812) 460-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141210000067 IN Practitioner - Chiropractic 8426227232
I20220825003938 WI Practitioner - Chiropractic 8426227232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tenold Chiropractic LLCGroup PAC ID 1951589498, 3 clinicians

Practice addresses (Care Compare)

3814 Oakwood Hills Pkwy
Eau Claire, WI 54701-7757
Phone 715833877719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002805AINMDChiropractor
5281KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tenold Chiropractic LLC Chiropractor CurrentSince Aug 11, 2022 Accepting new patients
Jason W Luking D.C. PLC Chiropractor PastSince Jan 7, 2013 Accepting new patients
Wisconsin Center for Integrative Health, SC Chiropractor PastSince Aug 11, 2022 Accepting new patients
Meadowland Healing Arts PLLC Chiropractor Past Accepting new patients

Locations

3814 Oakwood Hills Pkwy
Eau Claire, WI 54701
Phone (715) 833-8777

Organizations & group practices 4

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": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1487952933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1549 FORT HARRISON RD",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478041332",
            "telephone_number": "812-460-4700",
            "fax_number": "812-460-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1549 FORT HARRISON RD",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478041332",
            "telephone_number": "812-460-4700",
            "fax_number": "812-460-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KEVIN",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-08",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002805A",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.