Active NPI
Kenneth L Koris, DC
- Chiropractor
- South Sioux City, NE
National Provider Identifier
1851558233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1060
- Practice address
- 1915 Dakota Ave
South Sioux City, NE 68776-2737 - Phone
- (402) 494-8482
- Fax
- (402) 494-1126
- NPI assigned
- May 22, 2008
- Last updated
- Nov 2, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 1060 | NE | Primary |
Addresses
Primary practice location
1915 Dakota Ave
South Sioux City, NE 68776-2737
Mailing address
PO Box 51
Seabeck, WA 98380-0051
Phone (712) 276-4325
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 |
|---|---|---|---|
| 1060 | NE | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradlee N Novotny, D.C., P.C. | Chiropractor | Past | Accepting new patients |
| Doyle & Associates Chiropractic Clinic Inc PS | Chiropractor | Past | 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.
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Chiropractor
-
- Chiropractor
- Bremerton, WA
- NPI 1346545829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1851558233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 51",
"city": "SEABECK",
"state": "WA",
"postal_code": "983800051",
"telephone_number": "712-276-4325",
"fax_number": "712-276-6033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 DAKOTA AVE",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687762737",
"telephone_number": "402-494-8482",
"fax_number": "402-494-1126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORIS",
"first_name": "KENNETH",
"middle_name": "L",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-22",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NE",
"license": "1060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Sioux City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.