Organization Active NPI

Kennedy Chiropractic P.C.

  • Chiropractor
  • Cherokee, IA
National Provider Identifier
1619107372
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7166 Issued in IA
Legal business name
KENNEDY CHIROPRACTIC P.C.
Practice address
701 S 2ND St
Box 59
Cherokee, IA 51012-2178
Phone
(712) 225-2423
Fax
(712) 225-2621
NPI assigned
Jul 16, 2009
Last updated
Jul 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
Dr. Daniel Allen Kennedy, D.C.NPI 1114165016
Title
President
Phone
(712) 225-2423

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7166 IA Primary

Addresses

Primary practice location

701 S 2ND St
Box 59
Cherokee, IA 51012-2178

Mailing address

701 S 2ND St
Box 59
Cherokee, IA 51012-2178
Phone (712) 225-2423

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100115000772 IA Part B Supplier - Clinic/Group Practice 0042352833 Receives reassigned benefits from 1 practitioner
Practice locations: Cherokee, IA

National Provider Directory

National Provider Directory

Locations

701 S 2nd St
#59
Cherokee, IA 51012
Phone (712) 225-2423

Practitioners & affiliated clinicians

Practitioners 2

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": "1247702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1619107372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S 2ND ST",
            "address_2": "BOX 59",
            "city": "CHEROKEE",
            "state": "IA",
            "postal_code": "510122178",
            "telephone_number": "712-225-2423",
            "fax_number": "712-225-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S 2ND ST",
            "address_2": "BOX 59",
            "city": "CHEROKEE",
            "state": "IA",
            "postal_code": "510122178",
            "telephone_number": "712-225-2423",
            "fax_number": "712-225-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-225-2423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "7166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; 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.