Individual provider Active NPI

Kurt M. Gutknecht

  • Radiology Chiropractor
  • Levittown, PA
National Provider Identifier
1861585416
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
License
D.C. 002928-L Issued in PA
Practice address
75 Vermillion Dr
Levittown, PA 19054-1227
Phone
(215) 949-2292
Fax
(215) 945-5692
NPI assigned
Oct 2, 2006
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Chiropractor 111NR0200X D.C. 002928-L PA Primary

Addresses

Primary practice location

75 Vermillion Dr
Levittown, PA 19054-1227

Mailing address

75 Vermillion Dr
Levittown, PA 19054-1227
Phone (267) 261-1453

Other identifiers 2

IdentifierTypeStateIssuer
D.C.-002928-LOtherPASTATE LICENSE
0023216000OtherPABLUE CROSS/SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111107000516 PA Practitioner - Chiropractic 9335321934 Practice locations: Lehighton, PA; Levittown, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1609 Woodbourne Rd
Suite 201 B
Levittown, PA 19057-1533
Phone (267) 261-1453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D.C. 002928-LPAMDRadiology Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1861585416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VERMILLION DR",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190541227",
            "telephone_number": "267-261-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VERMILLION DR",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190541227",
            "telephone_number": "215-949-2292",
            "fax_number": "215-945-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTKNECHT",
        "first_name": "KURT",
        "middle_name": "M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "PA",
            "license": "D.C. 002928-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "D.C.-002928-L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD",
            "identifier": "0023216000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.