Individual provider Active NPI

Sean Matthew Dunivent, D.C.

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1619026275
Registry record updated Mar 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2005026319 Issued in MO
Practice address
9205 NE Highway 152
Kansas City, MO 64158-7608
Phone
(816) 781-2090
Fax
(816) 781-2092
NPI assigned
Jan 10, 2007
Last updated
Mar 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 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 2005026319 MO Primary

Addresses

Primary practice location

9205 NE Highway 152
Kansas City, MO 64158-7608

Mailing address

9205 NE Highway 152
Kansas City, MO 64158-7608
Phone (816) 781-2090

Other identifiers 4

IdentifierTypeStateIssuer
7245620OtherMOAETNA PPO
7398818OtherMOAETNA
36352029OtherMOBCBS
5762118OtherMOCOVNTRY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051201000088 MO Practitioner - Chiropractic 5193745446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8414 Church Rd
Kansas City, MO 64157-1204
Phone (816) 781-2090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoal Creek Chiropractic PC Chiropractor CurrentSince Jul 1, 2007 Accepting new patients
Richmond Chiropractic Center Chiropractor PastSince Sep 16, 2013 Accepting new patients
Renny Russell DC PC Chiropractor Past Accepting new patients

Locations

8414 Church Rd
Kansas City, MO 64157
Phone (816) 781-2090

9205 NE Highway 152
Kansas City, MO 64158
Phone (816) 781-2090

Organizations & group practices 3

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205539200000",
    "number": "1619026275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9205 NE HIGHWAY 152",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641587608",
            "telephone_number": "816-781-2090",
            "fax_number": "816-781-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 NE HIGHWAY 152",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641587608",
            "telephone_number": "816-781-2090",
            "fax_number": "816-781-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNIVENT",
        "first_name": "SEAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2005026319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7245620",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7398818",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36352029",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVNTRY",
            "identifier": "5762118",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

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