Individual provider Active NPI

Kye Matherne, DC

  • Chiropractor
  • Raceland, LA
National Provider Identifier
1679219455
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1952 Issued in TX
Practice address
4777 Highway 1
Raceland, LA 70394-2626
Phone
(985) 537-5512
NPI assigned
May 5, 2022
Last updated
May 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1952 TX Primary

Addresses

Primary practice location

4777 Highway 1
Raceland, LA 70394-2626

Mailing address

4777 Highway 1
Raceland, LA 70394-2626
Phone (985) 537-5512

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111003677 MI Practitioner - Chiropractic 5890175681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dawson Family Chiropractic PracticeGroup PAC ID 6103112420, 4 clinicians

Practice addresses (Care Compare)

1170 W Michigan Ave
Marshall, MI 49068-1497
Phone (269) 781-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1952TXMDProsthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dawson Family Chiropractic Practice Chiropractor CurrentSince Nov 28, 2023 Accepting new patients

Locations

510 Columbia Ave E
Battle Creek, MI 49014
Phone (269) 979-2566

1170 W Michigan Ave
Marshall, MI 49068
Phone (269) 781-4700

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, 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": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1679219455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 HIGHWAY 1",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "703942626",
            "telephone_number": "985-537-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 HIGHWAY 1",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "703942626",
            "telephone_number": "985-537-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERNE",
        "first_name": "KYE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "1952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raceland, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.