Individual provider Active NPI

Ross H Kerievsky, DC, ND

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1548308323
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5581 Issued in AZ
Practice address
1480 E Bethany Home Rd
Suite 230
Phoenix, AZ 85014-2003
Phone
(602) 870-8788
Fax
(602) 274-3000
NPI assigned
Feb 2, 2007
Last updated
Jan 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5581 AZ Primary
Naturopath 175F00000X 00-603 AZ

Addresses

Primary practice location

1480 E Bethany Home Rd
Suite 230
Phoenix, AZ 85014-2003

Mailing address

1480 E Bethany Home Rd
Suite 230
Phoenix, AZ 85014-2003
Phone (602) 870-8788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00-603AZMDNaturopath
5581AZMDPediatric Physical Therapist

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, 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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1548308323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 E BETHANY HOME RD",
            "address_2": "SUITE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142003",
            "telephone_number": "602-870-8788",
            "fax_number": "602-274-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 E BETHANY HOME RD",
            "address_2": "SUITE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142003",
            "telephone_number": "602-870-8788",
            "fax_number": "602-274-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERIEVSKY",
        "first_name": "ROSS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DC, ND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5581",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "00-603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.