Individual provider Active NPI

Vincent J Kalkowski, D.C.

  • Chiropractor
  • Cody, WY
National Provider Identifier
1740351071
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
564 Issued in WY
Practice address
1408 17TH St
Cody, WY 82414-4303
Phone
(307) 587-1500
Fax
(307) 587-5073
NPI assigned
Nov 10, 2006
Last updated
Jun 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 564 WY Primary

Addresses

Primary practice location

1408 17TH St
Cody, WY 82414-4303

Mailing address

1408 17TH St
Cody, WY 82414-4303
Phone (307) 587-1500

Other identifiers 1

IdentifierTypeStateIssuer
311052OtherWYBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100127000451 WY Practitioner - Chiropractic 7416099536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1408 17TH St
Cody, WY 82414-4303
Phone (307) 587-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
564WYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vincent Kalkowski DC PC Chiropractor CurrentSince Jul 1, 2001 Accepting new patients

Locations

1408 17th St
Cody, WY 82414
Phone (307) 587-1500

Organizations & group practices 1

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1740351071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 17TH ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824144303",
            "telephone_number": "307-587-1500",
            "fax_number": "307-587-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 17TH ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824144303",
            "telephone_number": "307-587-1500",
            "fax_number": "307-587-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALKOWSKI",
        "first_name": "VINCENT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "311052",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.