Health Source KC Inc
Organization Active NPI Chiropractor · Roeland Park, KS
NPI 1841645686 · NPPES record last updated May 25, 2016
Key facts
- NPI
- 1841645686
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- HEALTH SOURCE KC INC
- Practice address
- 5228 Juniper Dr
Roeland Park, KS 66205-2124 - Phone
- (816) 294-2281
- NPI assigned
- Apr 29, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Ryan M. Nadolski, D.C
- Title
- Owner/Clinic Director
- Phone
- (816) 294-2281
Practitioners 1
-
Ryan Nadolski, D.C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160608000186 | KS | Part B Supplier - Clinic/Group Practice | 5193015915 |
Receives reassigned benefits from 1 practitioner Practice locations: Mission, KS |
National Provider Directory
Locations
5424 Johnson Dr
Roeland Park, KS 66205
Phone (816) 294-2281
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes | ||
| Rehabilitation Chiropractor |
111NR0400X |
Addresses
Primary practice location
5228 Juniper Dr
Roeland Park, KS 66205-2124
Mailing address
5424 Johnson Dr
Mission, KS 66205-2911
Phone (816) 294-2281
Other providers in Roeland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.