Organization Active NPI

Vanessa Koutalidis D.C. and Kathleen Schklair D.C., P.a.

  • Chiropractor
  • Wilton Manors, FL
National Provider Identifier
1851578587
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7796 Issued in FL
Legal business name
VANESSA KOUTALIDIS D.C. AND KATHLEEN SCHKLAIR D.C., P.A.
Practice address
1749 NE 26TH St
Suite F
Wilton Manors, FL 33305-1428
Phone
(954) 566-1349
Fax
(954) 566-1385
NPI assigned
Jan 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Authorized official

Name
Kathleen M Schklair, D.C.
Title
Chiropractor
Phone
(954) 566-1349

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH7796 FL Primary

Addresses

Primary practice location

1749 NE 26TH St
Suite F
Wilton Manors, FL 33305-1428

Mailing address

1749 NE 26TH St
Suite F
Wilton Manors, FL 33305-1428
Phone (954) 566-1349

Other identifiers 1

IdentifierTypeStateIssuer
1922181833OtherFLNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041112000717 FL Part B Supplier - Clinic/Group Practice 7214991918 Receives reassigned benefits from 2 practitioners
Practice locations: Wilton Manors, FL

National Provider Directory

National Provider Directory

Locations

1749 NE 26th St
Ste F
Wilton Manors, FL 33305
Phone (954) 390-0911

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383264000000",
    "number": "1851578587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 NE 26TH ST",
            "address_2": "SUITE F",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051428",
            "telephone_number": "954-566-1349",
            "fax_number": "954-566-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 NE 26TH ST",
            "address_2": "SUITE F",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051428",
            "telephone_number": "954-566-1349",
            "fax_number": "954-566-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANESSA KOUTALIDIS D.C. AND KATHLEEN SCHKLAIR D.C., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2013-11-01",
        "status": "A",
        "authorized_official_last_name": "SCHKLAIR",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "954-566-1349",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1922181833",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.