Kelly Waters Dunklow

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

006.0109165 Issued in VT

Practice address

69 Center Rd
Essex Junction, VT 05452-2622

Phone

(802) 662-1047

NPI assigned

Mar 2, 2015

Last updated

Mar 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Chiropractic Center LLCGroup PAC ID 0345568788, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Chiropractic Center LLC

  • Chiropractor
  • Essex Junction, VT
  • NPI 1154713170
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1710379672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 CENTER RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522622",
            "telephone_number": "802-662-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 CENTER RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522622",
            "telephone_number": "802-662-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKLOW",
        "first_name": "KELLY",
        "middle_name": "WATERS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006.0109165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hella Douglas, APRN BC ADULT PSYCH
• Casandra Douglass, PT
• DRS. Mehaffey, LLC
• Felicia Drummond
• Sarah Kay Dudley, APRN
• Tilyr Alfred Dunklow, D.C., B.S.
• Mark Dziadek, MPT
• Blagorodna Efremovski, LCMHC., LADC
• Jen Ellis, M.S., M.ED.
• Ellsworth Physical Therapy, Inc.

• Chiropractor in Essex Junction, VT
• Providers in Essex Junction, VT by specialty
• Chiropractor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.