Individual provider Active NPI

Bryant L Kitchen, D.C.

  • Chiropractor
  • Rogue River, OR
National Provider Identifier
1508130774
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5044 Issued in OR
Practice address
230 E Main St
Rogue River, OR 97537-9416
Phone
(541) 582-2323
Fax
(541) 582-2419
NPI assigned
Mar 5, 2012
Last updated
Jun 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5044 OR Primary

Addresses

Primary practice location

230 E Main St
Rogue River, OR 97537-9416

Mailing address

1744 E McAndrews Rd
Ste D
Medford, OR 97504-5576
Phone (541) 582-2323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120424000466 OR Practitioner - Chiropractic 8921260761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Southern Oregon Chiropractic-Central Point, LLCGroup PAC ID 5395095434, 3 clinicians

Practice addresses (Care Compare)

547 E Pine St
Suite 102
Medford, OR 97502-2444
Phone (541) 414-0362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5044ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Chiropractic-Central Point, LLC Chiropractor CurrentSince Jun 1, 2021 Accepting new patients

Locations

1744 E McAndrews Rd
Ste D
Medford, OR 97504

547 E Pine St
Ste 102
Medford, OR 97502
Phone (541) 245-4444

891 Ohare Pkwy
Medford, OR 97504
Phone (541) 200-2243

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, 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": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1508130774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 E MCANDREWS RD",
            "address_2": "STE D",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045576",
            "telephone_number": "541-582-2323",
            "fax_number": "541-582-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E MAIN ST",
            "city": "ROGUE RIVER",
            "state": "OR",
            "postal_code": "975379416",
            "telephone_number": "541-582-2323",
            "fax_number": "541-582-2419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHEN",
        "first_name": "BRYANT",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-05",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogue River, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.