Individual provider Active NPI

Kenneth Robert Weil, DC

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1639108079
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5608 Issued in GA
Practice address
1715 Howell Mill Rd NW
C-12
Atlanta, GA 30318-3121
Phone
(404) 350-8000
Fax
(404) 350-8072
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5608 GA Primary

Addresses

Primary practice location

1715 Howell Mill Rd NW
C-12
Atlanta, GA 30318-3121

Mailing address

1715 Howell Mill Rd NW Ste C12
Atlanta, GA 30318-3117
Phone (404) 350-8000

Other identifiers 2

IdentifierTypeStateIssuer
35ZCDQPOtherGAMEDICARE
672394OtherGABLUE CROSS BLUE SHIELD #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5608GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kilpatrick Chiro LLC Chiropractor CurrentSince Nov 3, 2019 Accepting new patients

Locations

1715 Howell Mill Rd NW
Ste C12
Atlanta, GA 30318
Phone (404) 350-8000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1639108079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 HOWELL MILL RD NW STE C12",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303183117",
            "telephone_number": "404-350-8000",
            "fax_number": "404-350-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 HOWELL MILL RD NW",
            "address_2": "C-12",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303183121",
            "telephone_number": "404-350-8000",
            "fax_number": "404-350-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIL",
        "first_name": "KENNETH",
        "middle_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "5608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "35ZCDQP",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "672394",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.