Individual provider Active NPI

James Bryan Kickland, D.C.

  • Chiropractor
  • Atlantic, IA
National Provider Identifier
1528061736
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05647 Issued in IA
Practice address
1101 E. 7TH St
Atlantic, IA 50022-1812
Phone
(712) 243-5790
Fax
(712) 243-3975
NPI assigned
May 23, 2005
Last updated
Aug 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05647 IA Primary

Addresses

Primary practice location

1101 E. 7TH St
Atlantic, IA 50022-1812

Mailing address

1101 E. 7TH St.
Atlantic, IA 50022-1812
Phone (712) 243-5790

Other identifiers 1

IdentifierTypeStateIssuer
1135848MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117000814 IA Practitioner - Chiropractic 5991769010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Health Center PCGroup PAC ID 9931261641, 2 clinicians

Practice addresses (Care Compare)

1101 E 7TH St
Atlantic, IA 50022-1812
Phone (712) 243-5790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05647IAMDClinical Social Worker
A05647IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Health Center, PC Chiropractor CurrentSince Sep 12, 2002 Accepting new patients

Locations

1101 E 7th St
Atlantic, IA 50022
Phone (712) 243-5790

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1528061736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E. 7TH ST.",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221812",
            "telephone_number": "712-243-5790",
            "fax_number": "712-243-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E. 7TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221812",
            "telephone_number": "712-243-5790",
            "fax_number": "712-243-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICKLAND",
        "first_name": "JAMES",
        "middle_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1135848",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.