Individual provider Active NPI

Glenn J Kneeland, D.C.

  • Chiropractor
  • Salem, NH
National Provider Identifier
1518068170
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
062-0491-A Issued in NH
Practice address
53 Stiles Rd
Suite 105
Salem, NH 03079-2889
Phone
(603) 898-0030
Fax
(603) 894-6343
NPI assigned
Sep 26, 2006
Last updated
May 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 062-0491-A NH Primary
Chiropractor 111N00000X 1633 MA

Addresses

Primary practice location

53 Stiles Rd
Suite 105
Salem, NH 03079-2889

Mailing address

48 Stiles Rd
Ste 103
Salem, NH 03079-2845
Phone (603) 898-0030

Other identifiers 1

IdentifierTypeStateIssuer
30251660MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120110000796 NH Practitioner - Chiropractic 2365525136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Chiropractic Center, PCGroup PAC ID 4789603283, 2 clinicians

Practice addresses (Care Compare)

58 Range Rd
Suite R 03
Windham, NH 03087-2026
Phone (603) 898-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1633MAMDClinical Psychologist

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1518068170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 STILES RD",
            "address_2": "STE 103",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792845",
            "telephone_number": "603-898-0030",
            "fax_number": "603-894-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 STILES RD",
            "address_2": "SUITE 105",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792889",
            "telephone_number": "603-898-0030",
            "fax_number": "603-894-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEELAND",
        "first_name": "GLENN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NH",
            "license": "062-0491-A",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1633",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30251660",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.