Active NPI
Kent Gene Carlomagno, D.C.
- Chiropractor
- San Rafael, CA
National Provider Identifier
1770768954
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 20, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC0158820
- Practice address
- 710 C St
Ste. 12
San Rafael, CA 94901-3857 - Phone
- (415) 721-7520
- Fax
- (415) 721-7535
- NPI assigned
- Jan 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC0158820 | CA | Primary |
Addresses
Primary practice location
710 C St
Ste. 12
San Rafael, CA 94901-3857
Mailing address
710 C St
Ste. 12
San Rafael, CA 94901-3857
Phone (415) 721-7520
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0158820 | Other | CA | STATE LICENSE NUMBER |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC0158820 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199664000000",
"number": "1770768954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 C ST",
"address_2": "STE. 12",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013857",
"telephone_number": "415-721-7520",
"fax_number": "415-721-7535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 C ST",
"address_2": "STE. 12",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013857",
"telephone_number": "415-721-7520",
"fax_number": "415-721-7535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLOMAGNO",
"first_name": "KENT",
"middle_name": "GENE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-07",
"last_updated": "2008-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC0158820",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "DC0158820",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.