Kenneth D Edgar, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3690 Issued in CO

Practice address

37 N Nevada Ave
Montrose, CO 81401-3904

Phone

(970) 249-7377

Fax

(970) 249-7379

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kensho Total Wellness Day Spa, LLC

  • Chiropractor
  • Montrose, CO
  • NPI 1700225018
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1992883961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 N NEVADA AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013904",
            "telephone_number": "970-249-7377",
            "fax_number": "970-249-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 N NEVADA AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013904",
            "telephone_number": "970-249-7377",
            "fax_number": "970-249-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGAR",
        "first_name": "KENNETH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Montrose, CO
• Providers in Montrose, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.