Individual provider Active NPI

Kimley Craig Hensley Jr., D.C.

  • Chiropractor
  • Kernersville, NC
National Provider Identifier
1932429958
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4085 Issued in NC
Practice address
900 Old Winston Rd
Suite 208
Kernersville, NC 27284-9964
Phone
(336) 904-0752
NPI assigned
Jun 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4085 NC Primary

Addresses

Primary practice location

900 Old Winston Rd
Suite 208
Kernersville, NC 27284-9964

Mailing address

900 Old Winston Rd
Suite 208
Kernersville, NC 27284-9964
Phone (336) 904-0752

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000797 NC Practitioner - Chiropractic 4981735404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

900 Old Winston Rd
Suite 208
Kernersville, NC 27284-9965
Phone (336) 904-0752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4085NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Family Chiropractic, PLLC Chiropractor CurrentSince May 9, 2014 Accepting new patients
Gys Chiro Inc Chiropractor PastSince Dec 1, 2005 Accepting new patients

Locations

900 Old Winston Rd
Ste 208
Kernersville, NC 27284
Phone (336) 263-9291

Organizations & group practices 2

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": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1932429958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 OLD WINSTON RD",
            "address_2": "SUITE 208",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849964",
            "telephone_number": "336-904-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 OLD WINSTON RD",
            "address_2": "SUITE 208",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849964",
            "telephone_number": "336-904-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "KIMLEY",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.