Active NPI
Kenneth Scott Fine, DC
- Chiropractor
- Canoga Park, CA
National Provider Identifier
1689771941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC25325
- Practice address
- 22330 Sherman Way
2C
Canoga Park, CA 91307 - Phone
- (818) 704-7211
- Fax
- (818) 347-2436
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC25325 | CA | Primary |
Addresses
Primary practice location
22330 Sherman Way
2C
Canoga Park, CA 91307
Mailing address
22330 Sherman Way
2C
Canoga Park, CA 91307
Phone (818) 704-7211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110217000766 | CA | Practitioner - Chiropractic | 9739360140 | Practice locations: Canoga Park, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Los Angeles, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
22330 Sherman Way
Suite C2
Canoga Park, CA 91303-1065
Phone (818) 704-7211
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC25325 | CA | MD | Chiropractor |
| 25325 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280188800000",
"number": "1689771941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22330 SHERMAN WAY",
"address_2": "2C",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "91307",
"telephone_number": "818-704-7211",
"fax_number": "818-347-2436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22330 SHERMAN WAY",
"address_2": "2C",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "91307",
"telephone_number": "818-704-7211",
"fax_number": "818-347-2436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINE",
"first_name": "KENNETH",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2010-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC25325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.