Individual provider Active NPI

Gary August Kehres, D.C.

  • Chiropractor
  • Roanoke, VA
National Provider Identifier
1578621561
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000649 Issued in VA
Practice address
2155 Electric Rd
Roanoke, VA 24018-2302
Phone
(540) 774-0910
Fax
(540) 774-0910
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000649 VA Primary

Addresses

Primary practice location

2155 Electric Rd
Roanoke, VA 24018-2302

Mailing address

2155 Electric Rd
Roanoke, VA 24018-2302
Phone (540) 774-0910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130508000417 VA Practitioner - Chiropractic 9537306691 Practice locations: Roanoke, VA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2155 Electric Rd
Suite a
Roanoke, VA 24018-2302
Phone (540) 774-0910

PO Box
Suite 20131
Roanoke, VA 24018

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578621561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240182302",
            "telephone_number": "540-774-0910",
            "fax_number": "540-774-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240182302",
            "telephone_number": "540-774-0910",
            "fax_number": "540-774-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHRES",
        "first_name": "GARY",
        "middle_name": "AUGUST",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.