Kyle Andrew Koenke, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

7157 Issued in AZ

Practice address

1066 N Power Rd Ste 104
Mesa, AZ 85205-5709

Phone

(480) 830-7288

Fax

(480) 985-7255

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Koenke Chiropractic, Inc.

  • Sports Physician Chiropractor
  • Mesa, AZ
  • NPI 1528242310
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497815575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 N POWER RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852055709",
            "telephone_number": "480-830-7288",
            "fax_number": "480-985-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 N POWER RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852055709",
            "telephone_number": "480-830-7288",
            "fax_number": "480-985-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENKE",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "AZ",
            "license": "7157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRBCBS",
            "identifier": "RRP00086254",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0943870",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Koclanis
• Mallory Kocmoud, M.S. CCC-SLP
• Kara Koelbel, FNP-BC
• Eric Koenig, MSN, APRN, FNP-C
• Koenke Chiropractic, Inc.
• Jessica Christine Koeppen
• Kent Koerber
• Tatum Kofmehl, OTD R/L
• Kohala Cardiovascular Interventions LLC
• Kohlhase

• Sports Physician Chiropractor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Sports Physician Chiropractor in Arizona

• 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.