Organization Active NPI

Koerner Chiropractic PA

Doing business as Koerner Chiropractic & Physical Therapy

  • Chiropractor
  • Ellis, KS
National Provider Identifier
1578838868
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KOERNER CHIROPRACTIC PA
Doing business as
Koerner Chiropractic & Physical Therapy
Practice address
105 W 9TH St
Ellis, KS 67637-2206
Phone
(785) 726-3452
Fax
(785) 726-4007
NPI assigned
Mar 20, 2012
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Dr. Kenneth Joseph Koerner, DCNPI 1558501254
Title
Owner/President
Phone
(785) 628-2105

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

105 W 9TH St
Ellis, KS 67637-2206

Mailing address

105 W 9TH St
Ellis, KS 67637-2206
Phone (785) 726-3452

Other names 1

  • Koerner Chiropractic & Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100601000330 KS Part B Supplier - Clinic/Group Practice 8921137993 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellis, KS; Hays, KS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1504 Vine St
#B
Hays, KS 67601
Phone (785) 628-2105

520 W Mill St
Plainville, KS 67663
Phone (785) 688-4277

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1578838868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W 9TH ST",
            "city": "ELLIS",
            "state": "KS",
            "postal_code": "676372206",
            "telephone_number": "785-726-3452",
            "fax_number": "785-726-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 9TH ST",
            "city": "ELLIS",
            "state": "KS",
            "postal_code": "676372206",
            "telephone_number": "785-726-3452",
            "fax_number": "785-726-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOERNER CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "KOERNER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "785-628-2105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koerner Chiropractic & Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellis, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.