Individual provider Active NPI

Jimmy Scott Keutzer, DC

  • Chiropractor
  • Blue Springs, MO
National Provider Identifier
1780463398
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2023035381 Issued in MO
Practice address
3420 NW Duncan Rd # 3
Blue Springs, MO 64015-6419
Phone
(417) 262-3944
NPI assigned
Sep 22, 2023
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2023035381 MO Primary

Addresses

Primary practice location

3420 NW Duncan Rd # 3
Blue Springs, MO 64015-6419

Mailing address

3420 NW Duncan Rd # 3
Blue Springs, MO 64015-6419
Phone (417) 262-3944

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

State licenses

LicenseStateTypeSpecialty
2023035381MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1780463398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 NW DUNCAN RD # 3",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640156419",
            "telephone_number": "417-262-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 NW DUNCAN RD # 3",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640156419",
            "telephone_number": "417-262-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEUTZER",
        "first_name": "JIMMY",
        "middle_name": "SCOTT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2023035381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.