Kimbra Nicole Runyan

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013184 Issued in IL

Practice address

1607 E Main St Ste 2a
St Charles, IL 60174-2390

Phone

(331) 222-9667

NPI assigned

Feb 16, 2018

Last updated

Jun 19, 2020By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Runyan Chiropractic LLC

  • Chiropractor
  • St Charles, IL
  • NPI 1497228746
  Authorized official Same address or phone

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1710487756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 COMSTOCK DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601243811",
            "telephone_number": "847-691-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 E MAIN ST STE 2A",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742390",
            "telephone_number": "331-222-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNYAN",
        "first_name": "KIMBRA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdalena Rozycki, MSW
• Anna Linnea Rucinova, MA, ALMFT
• Anna Ruffalo, RBT
• Nevin Jai Runge
• Runyan Chiropractic LLC
• Rush-Select Holdings, LLC. (Rush Kids Pediatric Therapy)
• Rush-Select Holdings, LLC. (Rush Kids Pediatric Therapy)
• Margarita Munoz Rusiana
• Kerry Russell
• Sarah Marie Russell, M.A., CCC-SLP

• Chiropractor in St Charles, IL
• Providers in St Charles, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.