Organization Active NPI

Kuehne Chiropractic and Wellness Center, Inc.

  • Chiropractor
  • Kings Beach, CA
National Provider Identifier
1720647639
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KUEHNE CHIROPRACTIC AND WELLNESS CENTER, INC.
Practice address
695 Wolf St # 2979
Kings Beach, CA 96143-4503
Phone
(530) 546-8201
NPI assigned
Jun 13, 2019
Last updated
Feb 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Mrs. Debra A. Green
Title
Office Manager
Phone
(530) 546-8201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

695 Wolf St # 2979
Kings Beach, CA 96143-4503

Mailing address

695 Wolf St # 2979
Kings Beach, CA 96143-4503
Phone (530) 546-8201

Other identifiers 1

IdentifierTypeStateIssuer
DC21056OtherCALICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200204001452 CA Part B Supplier - Clinic/Group Practice 0840626297 Receives reassigned benefits from 1 practitioner
Practice locations: Kings Beach, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1720647639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 WOLF ST # 2979",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "961434503",
            "telephone_number": "530-546-8201",
            "fax_number": "530-546-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 WOLF ST # 2979",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "961434503",
            "telephone_number": "530-546-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUEHNE CHIROPRACTIC AND WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-13",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "530-546-8201",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DC21056",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.