NPIMap

Organization Active NPI

Kadolph Chiropractic Clinic PC

  • Chiropractor
  • Bethany, MO
National Provider Identifier
1962659748
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12301736 Issued in MO
Legal business name
KADOLPH CHIROPRACTIC CLINIC PC
Practice address
1704 Main St.
Bethany, MO 64424-2064
Phone
(660) 425-3312
NPI assigned
Aug 22, 2008
Last updated
Aug 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

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

Authorized official

Name
Dr. Kelly J. KadolphNPI 1639114366
Title
President
Phone
(660) 425-3312

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12301736 MO Primary

Addresses

Primary practice location

1704 Main St.
Bethany, MO 64424-2064

Mailing address

1704 Main St
Bethany, MO 64424-2064
Phone (660) 425-3312

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1962659748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 MAIN ST",
            "city": "BETHANY",
            "state": "MO",
            "postal_code": "644242064",
            "telephone_number": "660-425-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 MAIN ST.",
            "city": "BETHANY",
            "state": "MO",
            "postal_code": "644242064",
            "telephone_number": "660-425-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KADOLPH CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-22",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "KADOLPH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-425-3312",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "12301736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethany, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.