Individual provider Active NPI

Kristine B Simonson, D.C.

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1538341920
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1021 Issued in NE
Practice address
701 N 132ND St
Omaha, NE 68154-4000
Phone
(402) 496-6090
Fax
(402) 496-6158
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 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 1021 NE Primary

Addresses

Primary practice location

701 N 132ND St
Omaha, NE 68154-4000

Mailing address

701 N 132ND St
Omaha, NE 68154-4000
Phone (402) 496-6090

Other identifiers 2

IdentifierTypeStateIssuer
47081680700MedicaidNE
271414OtherMEDICARE PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080415000627 NE Practitioner - Chiropractic 4789762832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

701 N 132ND St
Omaha, NE 68154-4000
Phone (402) 496-6090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1021NEMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Chiropractic Center PC Chiropractor CurrentSince Mar 3, 1999 Accepting new patients

Locations

701 N 132nd St
Omaha, NE 68154
Phone (402) 496-6090

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1538341920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 132ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544000",
            "telephone_number": "402-496-6090",
            "fax_number": "402-496-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 132ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544000",
            "telephone_number": "402-496-6090",
            "fax_number": "402-496-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "KRISTINE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47081680700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "271414",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.