Kenneth P. Wingrove, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2158 Issued in NM

Practice address

1700 N Butler Ave
Farmington, NM 87401-6331

Phone

(505) 634-9225

Fax

(505) 212-1195

NPI assigned

Oct 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

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 and National Provider Directory roles.

• Desert Hills Chiropractic, PA

  • Chiropractor
  • Farmington, NM
  • NPI 1649798810
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1568762441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N BUTLER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016331",
            "telephone_number": "505-634-9225",
            "fax_number": "505-212-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N BUTLER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016331",
            "telephone_number": "505-634-9225",
            "fax_number": "505-212-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGROVE",
        "first_name": "KENNETH",
        "middle_name": "P.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-26",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11626",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph A. Wilson, DMD, MSD, LLC
• Mary Louise Wilson, SLP, M.S.-CCC
• Stephanie Ann Wilson
• Madison Paris Wimbish, CPSW, CCSS, LSAA
• James B Winblad, M.D.
• Nicholas Richard Withem, DMD
• Peter C Witt, MD
• Kelsey Wolfe, NP
• Preston Wolff, PT, DPT
• Ashlee Wood

• Chiropractor in Farmington, NM
• Providers in Farmington, NM by specialty
• Chiropractor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.