Kevin Charles Otheim, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

941 Issued in MT

Practice address

1201 Central Ave
Ste 2
Great Falls, MT 59401-3776

Phone

(406) 771-8431

Fax

(406) 771-8432

NPI assigned

Mar 6, 2007

Last updated

Jun 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Back and Neck Clinic of Great Falls, P.C.

  • Chiropractor
  • Great Falls, MT
  • NPI 1043496755
  Authorized official Same address or phone

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1780714055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 CENTRAL AVE",
            "address_2": "STE 2",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013776",
            "telephone_number": "406-771-8431",
            "fax_number": "406-771-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 CENTRAL AVE",
            "address_2": "STE 2",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013776",
            "telephone_number": "406-771-8431",
            "fax_number": "406-771-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHEIM",
        "first_name": "KEVIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Chiropractor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.