Individual provider Active NPI

Donald J Krippendorf, D.C.

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1831292150
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0001769 Issued in FL
Practice address
4641 Park St N
St Petersburg, FL 33709-4023
Phone
(727) 544-7878
Fax
(727) 546-9253
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0001769 FL Primary
Neurology Chiropractor 111NN0400X CH0001769 FL

Addresses

Primary practice location

4641 Park St N
St Petersburg, FL 33709-4023

Mailing address

4641 Park Street North
St. Petersburg, FL 33709
Phone (727) 544-7878

Other identifiers 3

IdentifierTypeStateIssuer
89606OtherFLBLUE CROSS/BLUE SHIELD
050460200MedicaidFL
2214123OtherFLAETNA HMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110630000543 FL Practitioner - Chiropractic 3678562725 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
CH0001769FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Donald J. Krippendorf PA Chiropractor CurrentSince Jan 4, 1999 Accepting new patients

Locations

4641 Park St N
St Petersburg, FL 33709
Phone (727) 544-7878

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1831292150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 PARK STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33709",
            "telephone_number": "727-544-7878",
            "fax_number": "727-546-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 PARK ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337094023",
            "telephone_number": "727-544-7878",
            "fax_number": "727-546-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIPPENDORF",
        "first_name": "DONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0001769",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH0001769",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "89606",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050460200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2214123",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.