Individual provider Active NPI

J Donald Kazmerski, DC

  • Chiropractor
  • Dickson City, PA
National Provider Identifier
1669540340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC004762L Issued in PA
Practice address
Kazmerski Chiropractic 1100 Main St
Dickson City, PA 18519
Phone
(570) 489-9920
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

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 DC004762L PA Primary

Addresses

Primary practice location

Kazmerski Chiropractic 1100 Main St
Dickson City, PA 18519

Mailing address

Kazmerski Chiropractic 1100 Main St
Dickson City, PA 18519
Phone (570) 489-9920

Other identifiers 2

IdentifierTypeStateIssuer
000000075782OtherUNISON
0012534110004MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110322000837 PA Practitioner - Chiropractic 8426231804 Practice locations: Dickson City, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC004762LPAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669540340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KAZMERSKI CHIROPRACTIC 1100 MAIN ST",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "18519",
            "telephone_number": "570-489-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KAZMERSKI CHIROPRACTIC 1100 MAIN ST",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "18519",
            "telephone_number": "570-489-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZMERSKI",
        "first_name": "J DONALD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC004762L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000075782",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012534110004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickson City, PA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.