Northland Spine and Rehabilitation, LLC
Organization Active NPI Chiropractor · Kansas City, MO
NPI 1871865550 · NPPES record last updated Jan 27, 2012
Key facts
- NPI
- 1871865550
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2009013598 (MO)
- Legal business name
- NORTHLAND SPINE AND REHABILITATION, LLC
- Practice address
- 8002 N Oak Trfy
Suite 112
Kansas City, MO 64118-1268 - Phone
- (816) 569-5079
- Fax
- (816) 569-5298
- NPI assigned
- Jan 27, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Blake Mitchell Overly, D.C.
- Title
- Owner
- Phone
- (816) 569-5079
Practitioners 1
-
Blake Overly, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131219000707 | MO | Part B Supplier - Clinic/Group Practice | 7810124807 |
Receives reassigned benefits from 1 practitioner Practice locations: Kansas City, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2009013598 | MO | Yes |
Addresses
Primary practice location
8002 N Oak Trfy
Suite 112
Kansas City, MO 64118-1268
Mailing address
8002 N Oak Trfy
Suite 112
Kansas City, MO 64118-1268
Phone (816) 569-5079
Other providers in Kansas City, MO
- Northland Orthopedics & Sports Medicine, LLC
- Northland Psychiatric Specialists LLC
- Northland Psychiatry LLC
- Northland Radiology, Inc.
- Northland Rehabilitation & Health Care Center LLC
- Northland Wellness Center Inc
- Northland Women'S Health Care, P.C.
- Ryan Northup
- Northwest Regional Youth Center
- Northwoods Chiropractic PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.