K B Smith, D.C., LLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

KS-01-04499 Issued in KS

Legal business name

K B SMITH, D.C., LLC

Practice address

9209 W 110TH St BLDG 36
Overland Park, KS 66210-1401

Phone

(913) 648-8111

Fax

(913) 912-5870

NPI assigned

Jan 14, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Gina Nina Namaste, C.A.

Title

Office Manager

Phone

(913) 648-8111

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1891026852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9209 W 110TH ST BLDG 36",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101401",
            "telephone_number": "913-648-8111",
            "fax_number": "913-912-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9209 W 110TH ST BLDG 36",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101401",
            "telephone_number": "913-648-8111",
            "fax_number": "913-912-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K B SMITH, D.C., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "NAMASTE",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "NINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "913-648-8111",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C.A."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "KS",
            "license": "KS-01-04499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10895941",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Peterson LLC
• Matthew Michael July, PT, DPT, OCS
• Sonya Jurgens, CRNA
• Lori Stairs Bohnen Justice, BSN, MS-LMFT, JD
• Mariah Justus
• Molly Kabella, PHARMD
• Krisha Kackley
• Kadolph Chiropractic, LLC
• Zachary Craig Kadolph, D.C.
• Jean M Kaeberle, APRN

• Sports Physician Chiropractor in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Sports Physician Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.