Individual provider Active NPI

Wesley Vinton Kroll, D.C.

  • Chiropractor
  • Frostburg, MD
National Provider Identifier
1710004346
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01885 Issued in MD
Practice address
1 E Main St
Frostburg, MD 21532-1331
Phone
(301) 689-1200
Fax
(301) 689-1200
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S01885 MD Primary
Chiropractor 111N00000X 684 WV

Addresses

Primary practice location

1 E Main St
Frostburg, MD 21532-1331

Mailing address

1 E Main St
Frostburg, MD 21532-1331
Phone (301) 689-1200

Other identifiers 2

IdentifierTypeStateIssuer
370937OtherMDMAMSI
M589WVOtherMDBCBS OF MARYLAND, INC.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101221001005 MD Practitioner - Chiropractic 1355539008 Practice locations: Frostburg, MD

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 E Main St
Frostburg, MD 21532-1331

21 Frost Ave
Frostburg, MD 21532-1623
Phone (301) 689-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01885MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroll Chiropractic Chiropractor PastSince Jul 13, 1998 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710004346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E MAIN ST",
            "city": "FROSTBURG",
            "state": "MD",
            "postal_code": "215321331",
            "telephone_number": "301-689-1200",
            "fax_number": "301-689-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E MAIN ST",
            "city": "FROSTBURG",
            "state": "MD",
            "postal_code": "215321331",
            "telephone_number": "301-689-1200",
            "fax_number": "301-689-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "WESLEY",
        "middle_name": "VINTON",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01885",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "684",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "370937",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MARYLAND, INC.",
            "identifier": "M589WV",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frostburg, MD

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.