Kyle Matthew Ellensohn, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

007424 Issued in IA

Practice address

6110 NW 86TH St
Suite 102
Johnston, IA 50131-2257

Phone

(515) 276-4946

Fax

(515) 276-6535

NPI assigned

Sep 23, 2011

Last updated

Dec 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• A First Step Chiropractic P.L.C.

  dba Ellensohn, Chiropractic P.L.C.

  • Chiropractor
  • Osceola, IA
  • NPI 1235406273
  Medicare reassignment NPD Authorized official
• Simmer Chiropractic & Wellness Inc.

  • Chiropractor
  • Osceola, IA
  • NPI 1073950515
  NPD (past)

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1548543754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S MAIN ST",
            "address_2": "SUITE 102",
            "city": "OSCEOLA",
            "state": "IA",
            "postal_code": "502131416",
            "telephone_number": "641-342-2122",
            "fax_number": "641-342-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 NW 86TH ST",
            "address_2": "SUITE 102",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312257",
            "telephone_number": "515-276-4946",
            "fax_number": "515-276-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENSOHN",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelly Suzanne Eastin, MS, OTR-L
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• Penny Sue Emmons, COTA-L
• Amy Ann Entrekin, PT

• Chiropractor in Johnston, IA
• Providers in Johnston, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.