Individual provider Active NPI

Kevin L Utech, D.C.

  • Chiropractor
  • Grinnell, IA
National Provider Identifier
1548260524
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06792 Issued in IA
Practice address
629 West St S
Ste 300
Grinnell, IA 50112-8103
Phone
(641) 236-8000
Fax
(641) 236-8001
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 06792 IA Primary

Addresses

Primary practice location

629 West St S
Ste 300
Grinnell, IA 50112-8103

Mailing address

629 West St S
Suite 300
Grinnell, IA 50112-8103
Phone (641) 236-8000

Other identifiers 1

IdentifierTypeStateIssuer
39175OtherIABCBS OF IOWA PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060126000262 IA Practitioner - Chiropractic 2567476880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

629 W St S
Suite 300
Grinnell, IA 50112-8176
Phone (641) 236-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06792IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Utech Integrative Health, P.C. Chiropractor CurrentSince May 10, 2017 Accepting new patients
Converge Chiropractic PLLC Chiropractor CurrentSince Apr 17, 2020 Accepting new patients

Locations

629 West St S
Ste 300
Grinnell, IA 50112
Phone (641) 236-8000

603 6th Ave
Grinnell, IA 50112
Phone (641) 236-8988

Organizations & group practices 2

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1548260524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 WEST ST S",
            "address_2": "SUITE 300",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501128103",
            "telephone_number": "641-236-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 WEST ST S",
            "address_2": "STE 300",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501128103",
            "telephone_number": "641-236-8000",
            "fax_number": "641-236-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTECH",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA PROVIDER #",
            "identifier": "39175",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grinnell, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.