Individual provider Active NPI

Kory Lee Isley, D.C.

  • Chiropractor
  • Montgomery, MN
National Provider Identifier
1639249840
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3935 Issued in MN
Practice address
317 1St St S
Montgomery, MN 56069-1603
Phone
(507) 364-7500
Fax
(507) 364-7444
NPI assigned
Nov 8, 2006
Last updated
Jun 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 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 3935 MN Primary

Addresses

Primary practice location

317 1St St S
Montgomery, MN 56069-1603

Mailing address

1305 History CT NW
New Prague, MN 56071-2457
Phone (507) 364-7500

Other identifiers 2

IdentifierTypeStateIssuer
028R4ISOtherMNBCBS
338682100MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000612 MN Practitioner - Chiropractic 3072789353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic Specialists, Inc.Group PAC ID 3274517222, 4 clinicians

Practice addresses (Care Compare)

108 Creek LN S
Jordan, MN 55352-1202
Phone (952) 492-6363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Chiropractic Health Center of Prior Lake, PA Chiropractor PastSince Sep 16, 2000 Accepting new patients

Organizations & group practices 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1639249840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 HISTORY CT NW",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560712457",
            "telephone_number": "507-364-7500",
            "fax_number": "507-364-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 1ST ST S",
            "city": "MONTGOMERY",
            "state": "MN",
            "postal_code": "560691603",
            "telephone_number": "507-364-7500",
            "fax_number": "507-364-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLEY",
        "first_name": "KORY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "028R4IS",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338682100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.