Individual provider Active NPI

Kaitlin M Ross, DC

  • Chiropractor
  • Pensacola, FL
National Provider Identifier
1902105455
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10277 Issued in FL
Practice address
2475 E Nine Mile Rd
Suite F
Pensacola, FL 32514
Phone
(850) 791-6222
Fax
(850) 607-6822
NPI assigned
Mar 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10277 FL Primary

Addresses

Primary practice location

2475 E Nine Mile Rd
Suite F
Pensacola, FL 32514

Mailing address

2475 E Nine Mild Rd
Suite F
Pensacola, FL 32514
Phone (850) 791-6222

Other identifiers 2

IdentifierTypeStateIssuer
220EJOtherFLBLUECROSS BLUESHIELD OF FLORIDA
592-21490OtherALBLUECROSS BLUESHIELD OF ALABAMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131231001761 FL Practitioner - Chiropractic 8527296235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2475 E Nine Mile Rd
Suite I
Pensacola, FL 32514-7796
Phone (850) 791-6222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH10277FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Venture Chiropractic & Wellness LLC Chiropractor CurrentSince Nov 10, 2013 Accepting new patients

Locations

2475 E Nine Mile Rd
Ste I
Pensacola, FL 32514
Phone (850) 791-6222

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1902105455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 E NINE MILD RD",
            "address_2": "SUITE F",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32514",
            "telephone_number": "850-791-6222",
            "fax_number": "850-607-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 E NINE MILE RD",
            "address_2": "SUITE F",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32514",
            "telephone_number": "850-791-6222",
            "fax_number": "850-607-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KAITLIN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF FLORIDA",
            "identifier": "220EJ",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF ALABAMA",
            "identifier": "592-21490",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.