Individual provider Active NPI

Kyle G Schmitz, D.C.

  • Chiropractor
  • Imperial, MO
National Provider Identifier
1609052729
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2008001515 Issued in MO
Practice address
1502 Prehistoric Hill Dr
Imperial, MO 63052-2288
Phone
(636) 464-8828
Fax
(636) 464-8838
NPI assigned
Jan 18, 2008
Last updated
Jan 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2008001515 MO Primary

Addresses

Primary practice location

1502 Prehistoric Hill Dr
Imperial, MO 63052-2288

Mailing address

1502 Prehistoric Hill Dr
Imperial, MO 63052-2288
Phone (636) 464-8828

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080710000212 MO Practitioner - Chiropractic 0446322259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schmitz Chiropractic, LLCGroup PAC ID 4688746498, 2 clinicians

Practice addresses (Care Compare)

1502 Prehistoric Hill Dr
Imperial, MO 63052-2288
Phone (636) 464-8828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008001515MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Schmitz Chiropractic, LLC Chiropractor CurrentSince Mar 7, 2008 Accepting new patients

Locations

1502 Prehistoric Hill Dr
Imperial, MO 63052
Phone (636) 464-4000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1609052729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 PREHISTORIC HILL DR",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630522288",
            "telephone_number": "636-464-8828",
            "fax_number": "636-464-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 PREHISTORIC HILL DR",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630522288",
            "telephone_number": "636-464-8828",
            "fax_number": "636-464-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITZ",
        "first_name": "KYLE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2008001515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Imperial, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.