NPIMap

Organization Active NPI

Fountain of Life Family Chiropractic, Inc.

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1912020033
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FOUNTAIN OF LIFE FAMILY CHIROPRACTIC, INC.
Practice address
8335 N Congress Ave
Kansas City, MO 64152-2041
Phone
(816) 741-4711
Fax
(816) 741-0119
NPI assigned
Apr 6, 2007
Last updated
Apr 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Dr. Joseph Michael Knudson, D.C.NPI 1194847210
Title
President
Phone
(816) 741-4711

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

8335 N Congress Ave
Kansas City, MO 64152-2041

Mailing address

8335 N Congress Ave
Kansas City, MO 64152-2041
Phone (816) 741-4711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050307000522 MO Part B Supplier - Clinic/Group Practice 7911951512 Receives reassigned benefits from 2 practitioners
Practice locations: Kansas City, MO

National Provider Directory

National Provider Directory

Locations

8335 N Congress Ave
Kansas City, MO 64152
Phone (816) 741-0018

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1912020033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8335 N CONGRESS AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641522041",
            "telephone_number": "816-741-4711",
            "fax_number": "816-741-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8335 N CONGRESS AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641522041",
            "telephone_number": "816-741-4711",
            "fax_number": "816-741-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF LIFE FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "KNUDSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-741-4711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.