Individual provider Active NPI

Kade David Kanelakos, DC

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1720676398
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-06102 Issued in KS
Practice address
10841 W 87TH St Ste 200
Overland Park, KS 66214-1660
Phone
(913) 825-3900
NPI assigned
Jan 8, 2021
Last updated
Jan 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-06102 KS Primary

Addresses

Primary practice location

10841 W 87TH St Ste 200
Overland Park, KS 66214-1660

Mailing address

10 Lakeridge Dr
Arkansas City, KS 67005-4304
Phone (620) 446-0464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105002439 MO Practitioner - Chiropractic 6406260983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Grove Chiropractic LLCGroup PAC ID 9537527015, 2 clinicians

Practice addresses (Care Compare)

705 S Broadway
Oak Grove, MO 64075-8102
Phone (816) 625-1598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-06102KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Exculta Health and Wellness Single Specialty Current Accepting new patients
Oak Grove Chiropractic LLC Chiropractor CurrentSince Nov 12, 2023 Accepting new patients
Knudson & Kadolf Wellness Solutions, Inc. Chiropractor PastSince Jan 10, 2021 Accepting new patients
Brittain Chiropractic Inc Chiropractor PastSince Jan 10, 2021 Accepting new patients

Locations

705 S Broadway
Oak Grove, MO 64075
Phone (816) 625-1598

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1720676398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LAKERIDGE DR",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670054304",
            "telephone_number": "620-446-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10841 W 87TH ST STE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662141660",
            "telephone_number": "913-825-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANELAKOS",
        "first_name": "KADE",
        "middle_name": "DAVID",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-06102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.