Individual provider Active NPI

Kenneth J Kerwin, D.C.

  • Chiropractor
  • Greenfield, WI
National Provider Identifier
1972671097
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3271 Issued in WI
Practice address
8081 W Layton Ave
Greenfield, WI 53220-3712
Phone
(414) 282-9001
Fax
(414) 282-4140
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3271 WI Primary

Addresses

Primary practice location

8081 W Layton Ave
Greenfield, WI 53220-3712

Mailing address

8081 W Layton Ave
Greenfield, WI 53220-3712
Phone (414) 282-9001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427000514 WI Practitioner - Chiropractic 8022005628 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3271WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Spinal Relief, S.C. PastSince May 1, 2004 Accepting new patients

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1972671097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532203712",
            "telephone_number": "414-282-9001",
            "fax_number": "414-282-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532203712",
            "telephone_number": "414-282-9001",
            "fax_number": "414-282-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERWIN",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.