Individual provider Active NPI

Kayla Minniear, DC

  • Chiropractor
  • Bloomington, IN
National Provider Identifier
1841747490
Registry record updated Jul 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002841A Issued in IN
Practice address
1332 W Arch Haven Ave Ste C
Bloomington, IN 47403-2078
Phone
(812) 333-7447
Fax
(812) 333-7442
NPI assigned
Sep 1, 2016
Last updated
Jul 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002841A IN Primary

Addresses

Primary practice location

1332 W Arch Haven Ave Ste C
Bloomington, IN 47403-2078

Mailing address

1332 W Arch Haven Ave Ste C
Bloomington, IN 47403-2078
Phone (812) 333-7447

Other practice location 1

202 E Temperance St
Ellettsville, IN 47429-1836
Phone (260) 307-2673

Other identifiers 1

IdentifierTypeStateIssuer
300037063MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171120000097 IN Practitioner - Chiropractic 5496011884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osmon Chiropractic Center, LLCGroup PAC ID 3779672878, 3 clinicians

Practice addresses (Care Compare)

1332 W Arch Haven Ave
Suite C
Bloomington, IN 47403-2078
Phone (812) 333-7447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Body Balance Physical Medicine LLC Chiropractor Current Accepting new patients
Paragon Wellness Center, LLC Chiropractor CurrentSince Aug 1, 2022 Accepting new patients
Body Balance Physical Medicine LLC Current Accepting new patients
True Health Chiropractic and Sports Rehab, PLLC Chiropractor Past Accepting new patients
Community Physicians of Indiana Inc PastSince Oct 2, 2017 Accepting new patients

Locations

1332 W Arch Haven Ave
Ste C
Bloomington, IN 47403
Phone (812) 272-3700

Organizations & group practices 5

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657324800000",
    "number": "1841747490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 W ARCH HAVEN AVE STE C",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032078",
            "telephone_number": "812-333-7447",
            "fax_number": "812-333-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 W ARCH HAVEN AVE STE C",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032078",
            "telephone_number": "812-333-7447",
            "fax_number": "812-333-7442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 E TEMPERANCE ST",
            "address_purpose": "LOCATION",
            "city": "ELLETTSVILLE",
            "state": "IN",
            "postal_code": "474291836",
            "country_code": "US",
            "telephone_number": "260-307-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINNIEAR",
        "first_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2022-07-09",
        "certification_date": "2022-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002841A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300037063",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.