Individual provider Active NPI

Kathryn Lane Angelo, D.C.

  • Chiropractor
  • Hingham, MA
National Provider Identifier
1689896078
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1186 Issued in MA
Practice address
20 Downer Ave
Suite 1
Hingham, MA 02043-1115
Phone
(781) 740-2286
Fax
(781) 740-8214
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 Hingham St
Suite 100N
Rockland, MA 02370-1067
Phone (781) 792-3500

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20060502000021 MA Practitioner - Chiropractic 3476563750 Practice locations: Rockland, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1186MAMDPhysician Assistant

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1186 MA Primary

Addresses

NPPES NPI Registry

Primary practice location

20 Downer Ave
Suite 1
Hingham, MA 02043-1115

Mailing address

20 Downer Ave
Suite 1
Hingham, MA 02043-1115
Phone (781) 740-2286

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
Y35894OtherMABLUECROSSBLUESHIELD
1608126MedicaidMA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689896078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DOWNER AVE",
            "address_2": "SUITE 1",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020431115",
            "telephone_number": "781-740-2286",
            "fax_number": "781-740-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 DOWNER AVE",
            "address_2": "SUITE 1",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020431115",
            "telephone_number": "781-740-2286",
            "fax_number": "781-740-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELO",
        "first_name": "KATHRYN",
        "middle_name": "LANE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "Y35894",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1608126",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hingham, MA

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.
  • 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.