Individual provider Active NPI

Krystal Sherri Allen, D.C.

  • Chiropractor
  • Lodi, CA
National Provider Identifier
1659580702
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 30023 Issued in CA
Practice address
2000 W Kettleman LN Ste 104
Lodi, CA 95242-4334
Phone
(209) 334-6947
Fax
(209) 334-6969
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 30023 CA Primary

Addresses

Primary practice location

2000 W Kettleman LN Ste 104
Lodi, CA 95242-4334

Mailing address

PO Box 986
Woodbridge, CA 95258-0986
Phone (209) 339-9036

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080108000284 CA Practitioner - Chiropractic 2860572567 Reassigns benefits to 1 organization
Practice locations: Lodi, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Wilson and Allen Chiropractic CorporationGroup PAC ID 3678988425, 2 clinicians

Practice addresses (Care Compare)

2000 W Kettleman LN
Suite 104
Lodi, CA 95242-4334
Phone (209) 334-6947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 30023CAMDChiropractor
30023CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson & Allen Chiropractic Corporation Chiropractor CurrentSince Aug 14, 2020 Accepting new patients

Locations

2000 W Kettleman Ln
Ste 104
Lodi, CA 95242
Phone (209) 334-6947

Interoperability endpoints

  • Direct secure messaging: ksa@waac0002.direct.chirotouch.md

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1659580702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986",
            "city": "WOODBRIDGE",
            "state": "CA",
            "postal_code": "952580986",
            "telephone_number": "209-339-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W KETTLEMAN LN STE 104",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424334",
            "telephone_number": "209-334-6947",
            "fax_number": "209-334-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "KRYSTAL",
        "middle_name": "SHERRI",
        "name_prefix": "Ms.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 30023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.