Individual provider Active NPI

Christopher Aaron Ullom, D.C.

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1801040761
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4518 Issued in NC
Practice address
8764 W 95TH St
Overland Park, KS 66212-4049
Phone
(913) 383-2276
Fax
(913) 383-2279
NPI assigned
Nov 5, 2008
Last updated
Feb 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4518 NC Primary

Addresses

Primary practice location

8764 W 95TH St
Overland Park, KS 66212-4049

Mailing address

7101 Creedmoor Rd
Ste 102
Raleigh, NC 27613-1684
Phone (919) 848-3333

Other identifiers 1

IdentifierTypeStateIssuer
01-05290OtherKSSTATE LICENSE

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

LicenseStateTypeSpecialty
4518NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Group of Overland Park LLC Chiropractor PastSince Sep 20, 2010 Accepting new patients
Kevin Stallbaumer, D.C. LLC Chiropractor PastSince Apr 1, 2015 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1801040761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 CREEDMOOR RD",
            "address_2": "STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276131684",
            "telephone_number": "919-848-3333",
            "fax_number": "919-848-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8764 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662124049",
            "telephone_number": "913-383-2276",
            "fax_number": "913-383-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOM",
        "first_name": "CHRISTOPHER",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-05",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "01-05290",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.