Individual provider Active NPI

Christopher Hori Kelley, D.C.

  • Chiropractor
  • Roseville, CA
National Provider Identifier
1972876001
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 32218 Issued in CA
Practice address
151 N Sunrise Ave
Suite 907
Roseville, CA 95661-2924
Phone
(916) 786-5828
Fax
(916) 786-5055
NPI assigned
Feb 21, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 32218 CA Primary

Addresses

Primary practice location

151 N Sunrise Ave
Suite 907
Roseville, CA 95661-2924

Mailing address

151 N Sunrise Ave
Ste 701
Roseville, CA 95661-2927
Phone (916) 786-5828

Other identifiers 1

IdentifierTypeStateIssuer
DC 32218OtherCACA STATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121008000161 CA Practitioner - Chiropractic 4981853959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Kelley ChiropracticGroup PAC ID 4486567401, 2 clinicians

Practice addresses (Care Compare)

151 N Sunrise Ave
Suite 701
Roseville, CA 95661-2927
Phone (916) 786-5828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 32218CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Kelley Chiropractic Chiropractor CurrentSince Apr 30, 2023 Accepting new patients
Kelley Chiropractic Chiropractor CurrentSince Aug 17, 2012 Accepting new patients

Locations

151 N Sunrise Ave
Ste 907
Roseville, CA 95661
Phone (916) 786-5828

151 N Sunrise Ave
Ste 701
Roseville, CA 95661
Phone (916) 782-4440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1972876001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "address_2": "STE 701",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612927",
            "telephone_number": "916-786-5828",
            "fax_number": "916-786-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "address_2": "SUITE 907",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612924",
            "telephone_number": "916-786-5828",
            "fax_number": "916-786-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "HORI",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 32218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE",
            "identifier": "DC 32218",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; 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.