Active NPI
Neil Jordan Kjos, D.C.
- Nutrition Chiropractor
- Chattanooga, TN
National Provider Identifier
1871580464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 1430
- Practice address
- 3536 Cummings Hwy
Ste. 120
Chattanooga, TN 37419-2435 - Phone
- (423) 825-5252
- Fax
- (423) 825-1228
- NPI assigned
- Sep 29, 2005
- Last updated
- Nov 30, 2010
- 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 |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 1430 | TN | Primary |
Addresses
Primary practice location
3536 Cummings Hwy
Ste. 120
Chattanooga, TN 37419-2435
Mailing address
3536 Cummings Hwy
Ste. 120
Chattanooga, TN 37419-2435
Phone (423) 825-5252
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5011638 | Other | TN | AETNA PIN |
| 350052346 | Other | GA | RAILROAD MC/PALMETTO GBA |
| 3069538 | Other | TN | BLUE CROSS PIN |
| 621713923 | Other | TN | TAX ID NO. |
| 000933226A | Medicaid | GA |
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
Organizations & group practices 1
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.
-
- Sports Physician Chiropractor
- Chattanooga, TN
- NPI 1770663239
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291075200000",
"number": "1871580464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3536 CUMMINGS HWY",
"address_2": "STE. 120",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374192435",
"telephone_number": "423-825-5252",
"fax_number": "423-825-1228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3536 CUMMINGS HWY",
"address_2": "STE. 120",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374192435",
"telephone_number": "423-825-5252",
"fax_number": "423-825-1228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KJOS",
"first_name": "NEIL",
"middle_name": "JORDAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2010-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "TN",
"license": "1430",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "5011638",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MC/PALMETTO GBA",
"identifier": "350052346",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PIN",
"identifier": "3069538",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID NO.",
"identifier": "621713923",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000933226A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.