Individual provider Active NPI

Kenneth P Madore, D.C.

  • Chiropractor
  • Bridgewater, MA
National Provider Identifier
1659434124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
494 Issued in MA
Practice address
481 Bedford St
Bridgewater, MA 02324-3152
Phone
(508) 697-8899
Fax
(508) 697-8899
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 494 MA Primary

Addresses

Primary practice location

481 Bedford St
Bridgewater, MA 02324-3152

Mailing address

481 Bedford St
Bridgewater, MA 02324-3152
Phone (508) 697-8899

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090108000271 MA Practitioner - Chiropractic 4082777602 Practice locations: Bridgewater, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

481 Bedford St
Bridgewater, MA 02324-3152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
494MAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659434124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 BEDFORD ST",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023243152",
            "telephone_number": "508-697-8899",
            "fax_number": "508-697-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 BEDFORD ST",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023243152",
            "telephone_number": "508-697-8899",
            "fax_number": "508-697-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADORE",
        "first_name": "KENNETH",
        "middle_name": "P",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.