Organization Active NPI

Kumbalek Chiropractic Center SC

  • Chiropractor
  • Manitowoc, WI
National Provider Identifier
1972503316
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2338 Issued in WI
Legal business name
KUMBALEK CHIROPRACTIC CENTER SC
Practice address
2510 Washington St
Manitowoc, WI 54220-4858
Phone
(920) 683-3800
Fax
(920) 683-1230
NPI assigned
Jul 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kevin J Kumbalek, DC
Title
President
Phone
(920) 683-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2338 WI Primary

Addresses

Primary practice location

2510 Washington St
Manitowoc, WI 54220-4858

Mailing address

2510 Washington St
Manitowoc, WI 54220-4858
Phone (920) 683-3800

Other identifiers 1

IdentifierTypeStateIssuer
38837000MedicaidWI

National Provider Directory

National Provider Directory

Locations

2510 Washington St
Manitowoc, WI 54220
Phone (920) 629-6126

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972503316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 WASHINGTON ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204858",
            "telephone_number": "920-683-3800",
            "fax_number": "920-683-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 WASHINGTON ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204858",
            "telephone_number": "920-683-3800",
            "fax_number": "920-683-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUMBALEK CHIROPRACTIC CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUMBALEK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-683-3800",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38837000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.