NPIMap

Organization Active NPI

Allegiant Health and Laser

  • Chiropractor
  • Ottawa, KS
National Provider Identifier
1538698485
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05533 Issued in KS
Legal business name
ALLEGIANT HEALTH AND LASER
Practice address
112 E 17TH St
Ottawa, KS 66067-3800
Phone
(785) 242-9393
Fax
(913) 538-2289
NPI assigned
Jun 5, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Krystin Jade Provo, DCNPI 1598100448
Title
Owner
Phone
(785) 242-9393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05533 KS Primary

Addresses

Primary practice location

112 E 17TH St
Ottawa, KS 66067-3800

Mailing address

112 E 17TH St
Ottawa, KS 66067-3800
Phone (785) 242-9393

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1538698485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E 17TH ST",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660673800",
            "telephone_number": "785-242-9393",
            "fax_number": "913-538-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 17TH ST",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660673800",
            "telephone_number": "785-242-9393",
            "fax_number": "913-538-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGIANT HEALTH AND LASER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PROVO",
        "authorized_official_first_name": "KRYSTIN",
        "authorized_official_middle_name": "JADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-242-9393",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.