Organization Active NPI

Kaurich Chiropractic, PC

  • Chiropractor
  • South Bend, IN
National Provider Identifier
1568645323
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001607A Issued in IN
Legal business name
KAURICH CHIROPRACTIC, PC
Practice address
21421 Cleveland Rd
South Bend, IN 46628-3507
Phone
(574) 282-2828
Fax
(574) 282-1802
NPI assigned
Dec 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Dr. Kevin William Kaurich, D.C,NPI 1295768695
Title
Owner
Phone
(574) 282-2828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08001607A IN Primary

Addresses

Primary practice location

21421 Cleveland Rd
South Bend, IN 46628-3507

Mailing address

21421 Cleveland Rd
South Bend, IN 46628-3507
Phone (574) 282-2828

Other identifiers 1

IdentifierTypeStateIssuer
200032070MedicaidIN

Other names 2

  • Federal Injury Centers of South Bend Doing business as
  • Kaurich Chiropractic and Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080226000093 IN Part B Supplier - Clinic/Group Practice 1456385673 Receives reassigned benefits from 1 practitioner
Practice locations: South Bend, IN

National Provider Directory

National Provider Directory

Locations

21421 Cleveland Rd
South Bend, IN 46628
Phone (574) 282-2828

3511 Lincolnway W
South Bend, IN 46628
Phone (219) 282-2828

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1568645323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21421 CLEVELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466283507",
            "telephone_number": "574-282-2828",
            "fax_number": "574-282-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21421 CLEVELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466283507",
            "telephone_number": "574-282-2828",
            "fax_number": "574-282-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAURICH CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "KAURICH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-282-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C,"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001607A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200032070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Federal Injury Centers of South Bend",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaurich Chiropractic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaurich Chiropractic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.