NPIMap

Organization Active NPI

Kimel Chiropractic Center PC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1790729010
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5350 Issued in AZ
Legal business name
KIMEL CHIROPRACTIC CENTER PC
Practice address
13615 N 35TH Ave
#1
Phoenix, AZ 85029
Phone
(602) 993-1722
Fax
(602) 866-0219
NPI assigned
Jun 16, 2006
Organization subpart
Yes
Parent organization
KIMEL CHIROPRACTIC CENTER PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Authorized official

Name
Dr. Gene Bradley Kimel, DCNPI 1902848641
Title
Vice Pres
Phone
(602) 993-1722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 4269 AZ
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 5350 AZ Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 7481 AZ
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 7857 AZ

Addresses

Primary practice location

13615 N 35TH Ave
#1
Phoenix, AZ 85029

Mailing address

13615 N 35TH Ave
#1
Phoenix, AZ 85029
Phone (602) 993-1722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624001428 AZ Part B Supplier - Clinic/Group Practice 7416933130 Receives reassigned benefits from 4 practitioners
Practice locations: Glendale, AZ

National Provider Directory

National Provider Directory
Part of
Kimel Chiropractic Center PC

Locations

17250 N 43rd Ave
Ste 3
Glendale, AZ 85308
Phone (602) 993-1722

13615 N 35th Ave
Ste 1
Phoenix, AZ 85029
Phone (602) 993-1722

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1790729010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13615 N 35TH AVE",
            "address_2": "#1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85029",
            "telephone_number": "602-993-1722",
            "fax_number": "602-866-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13615 N 35TH AVE",
            "address_2": "#1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85029",
            "telephone_number": "602-993-1722",
            "fax_number": "602-866-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMEL CHIROPRACTIC CENTER PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIMEL CHIROPRACTIC CENTER PC",
        "enumeration_date": "2006-06-16",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "KIMEL",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "VICE PRES",
        "authorized_official_telephone_number": "602-993-1722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "4269",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5350",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7481",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.