Organization Active NPI

Kortmeyer Chiropractic Inc

  • Chiropractor
  • Cathedral City, CA
National Provider Identifier
1891164117
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
23036 Issued in CA
Legal business name
KORTMEYER CHIROPRACTIC INC
Practice address
34-950 Date Palm Drive
Cathedral City, CA 92234-6833
Phone
(760) 321-1453
Fax
(760) 324-6656
NPI assigned
Sep 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Authorized official

Name
David E Kortmeyer, D.C.NPI 1689748352
Title
President
Phone
(760) 321-1453

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 23036 CA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 22829 CA

Addresses

Primary practice location

34-950 Date Palm Drive
Cathedral City, CA 92234-6833

Mailing address

PO Box 1843
Cathedral City, CA 92235-1843
Phone (760) 321-1453

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190607001991 CA Part B Supplier - Clinic/Group Practice 5496088395 Receives reassigned benefits from 2 practitioners
Practice locations: Cathedral City, CA

National Provider Directory

National Provider Directory

Locations

34950 Date Palm Dr
Cathedral City, CA 92234
Phone (760) 321-1453

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": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1891164117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1843",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922351843",
            "telephone_number": "760-321-1453",
            "fax_number": "760-324-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34-950 DATE PALM DRIVE",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922346833",
            "telephone_number": "760-321-1453",
            "fax_number": "760-324-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORTMEYER CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "KORTMEYER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-321-1453",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "23036",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "22829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.