Individual provider Active NPI

Keith S Kinsley, D.C.

  • Chiropractor
  • Clinton, NC
National Provider Identifier
1558686386
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3983 Issued in NC
Practice address
346A Northeast Blvd
Clinton, NC 28328
Phone
(910) 592-1115
Fax
(910) 592-1541
NPI assigned
Apr 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3983 NC Primary

Addresses

Primary practice location

346A Northeast Blvd
Clinton, NC 28328

Mailing address

346A Northeast Blvd
Clinton, NC 28328
Phone (910) 592-1115

Other identifiers 1

IdentifierTypeStateIssuer
5916173MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141209002219 NC Practitioner - Chiropractic 9931232733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1558686386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346A NORTHEAST BLVD",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "28328",
            "telephone_number": "910-592-1115",
            "fax_number": "910-592-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346A NORTHEAST BLVD",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "28328",
            "telephone_number": "910-592-1115",
            "fax_number": "910-592-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSLEY",
        "first_name": "KEITH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916173",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.