Individual provider Active NPI

David Carl Kline, D.C.

  • Chiropractor
  • Bradley, IL
National Provider Identifier
1508053422
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038007032 Issued in IL
Practice address
956 W Broadway St
Bradley, IL 60915-2011
Phone
(815) 933-2246
Fax
(815) 933-2246
NPI assigned
Sep 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038007032 IL Primary

Addresses

Primary practice location

956 W Broadway St
Bradley, IL 60915-2011

Mailing address

956 W Broadway St
Bradley, IL 60915-2011
Phone (815) 933-2246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161202001685 IL Practitioner - Chiropractic 7012297344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

956 W Broadway St
Bradley, IL 60915-2011
Phone (815) 933-2246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kline Chiropractic LTD Chiropractor CurrentSince Oct 22, 2016 Accepting new patients
Dr.Joseph Mayotte D.C P.C Chiropractor PastSince Oct 22, 2016 Accepting new patients

Locations

956 W Broadway St
Bradley, IL 60915
Phone (815) 933-2246

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1508053422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 W BROADWAY ST",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609152011",
            "telephone_number": "815-933-2246",
            "fax_number": "815-933-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 W BROADWAY ST",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609152011",
            "telephone_number": "815-933-2246",
            "fax_number": "815-933-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "DAVID",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.