Individual provider Active NPI

Kennedy Shayne Riekenberg, DC

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1730859141
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-06147 Issued in KS
Practice address
11960 Quivira Rd Ste 200
Overland Park, KS 66213-2579
Phone
(913) 402-7444
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 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 01-06147 KS Primary

Addresses

Primary practice location

11960 Quivira Rd Ste 200
Overland Park, KS 66213-2579

Mailing address

11403 W 67TH Ter
Shawnee, KS 66203-3705
Phone (620) 338-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1730859141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11403 W 67TH TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662033705",
            "telephone_number": "620-338-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 QUIVIRA RD STE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132579",
            "telephone_number": "913-402-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEKENBERG",
        "first_name": "KENNEDY",
        "middle_name": "SHAYNE",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-06147",
            "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 Sep 16, 2021; 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.