Individual provider Active NPI

Kerry Lynn Keiser, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1497957302
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC22030 Issued in CA
Practice address
1274 Morena Blvd
San Diego, CA 92110-3815
Phone
(619) 276-7575
Fax
(619) 276-6362
NPI assigned
Jun 3, 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 DC22030 CA Primary

Addresses

Primary practice location

1274 Morena Blvd
San Diego, CA 92110-3815

Mailing address

549 Orange Ave
Coronado, CA 92118-1826
Phone (619) 437-4900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130221000412 CA Practitioner - Chiropractic 9234384389 Practice locations: Coronado, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1010 8TH St
Suite B
Coronado, CA 92118-2189
Phone (619) 437-4900

1010 8TH St B
Coronado, CA 92118-2189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22030CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen J Moffett OD a Professional PastSince Mar 4, 2003 Accepting new patients

Organizations & group practices 1

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": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497957302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 ORANGE AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181826",
            "telephone_number": "619-437-4900",
            "fax_number": "619-276-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1274 MORENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103815",
            "telephone_number": "619-276-7575",
            "fax_number": "619-276-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEISER",
        "first_name": "KERRY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC22030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, 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.