Active NPI
Kevin J Kumbalek, DC
- Chiropractor
- Manitowoc, WI
National Provider Identifier
1790863009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2338-012
- Practice address
- 2510 Washington St
Manitowoc, WI 54220-4858 - Phone
- (920) 683-3800
- Fax
- (920) 683-1230
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 2338-012 | WI | Primary |
Addresses
Primary practice location
2510 Washington St
Manitowoc, WI 54220-4858
Mailing address
2510 Washington St
Manitowoc, WI 54220-4858
Phone (920) 683-3800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38837000 | Medicaid | WI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2338-012 | WI | MD | Chiropractor |
| 2338 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1790863009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 WASHINGTON ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204858",
"telephone_number": "920-683-3800",
"fax_number": "920-683-1230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 WASHINGTON ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204858",
"telephone_number": "920-683-3800",
"fax_number": "920-683-1230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUMBALEK",
"first_name": "KEVIN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "2338-012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38837000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.