Kathleen Clare, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

5856 Issued in MN

Practice address

5250 W 74TH St Ste 8
Edina, MN 55439-2229

Phone

(952) 831-0242

NPI assigned

Jan 19, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kathleen Kjos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dauntless Health Services PLLC

  • Sports Physician Chiropractor
  • Eden Prairie, MN
  • NPI 1578296208
  NPD Authorized official

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

{
    "created_epoch": "1390089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1902228356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2746 STEVENS AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081644",
            "telephone_number": "952-831-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 W 74TH ST STE 8",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392229",
            "telephone_number": "952-831-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARE",
        "first_name": "KATHLEEN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-19",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5856",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "5856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "KJOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jerry Chung, M.D
• City of Edina
• City Psychiatric LLC
• Nicole Howard Claeson, LICSW
• Claire K Lowe Counseling LLC
• Clarity Chiropractic PLLC
• Carrie Ellen Clark, D.C.
• Melissa Clark, M.D.
• Sarah Pupkes Clark, PHARMD
• Delphia Mathilda Clarke, M.D.

• Sports Physician Chiropractor in Edina, MN
• Providers in Edina, MN by specialty
• Sports Physician Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; 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.