Ethan Kyle Komp, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2016010041 Issued in MO

Practice address

2310 Holmes St
Kansas City, MO 64108-2602

Phone

(816) 404-6489

NPI assigned

Jan 20, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myocore LLCGroup PAC ID 9830267277, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Myocore, LLC

  • Chiropractor
  • Kansas City, MO
  • NPI 1316138316
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1689063265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8139 RENNER RD APT 3",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662198009",
            "telephone_number": "785-760-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082602",
            "telephone_number": "816-404-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMP",
        "first_name": "ETHAN",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-20",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05675",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2016010041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Sean Kolega, PHARM.D.
• April Janelle Kolle, MSN-FN, RN, SANE
• Curtis J Kolle, LPC
• Joseph Kollhoff
• George Kolo, D.O.
• Sindhu Kondamu
• Kyong A Kong, DDS
• Kyong-Yun Kong, DDS
• Layne O'Bryan Konneman, DDS
• Kono Care Services

• Chiropractor in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.