DR. KEVIN RUSSELL MIKALAITIS (NPI# 1104008663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104008663 |
| Entity Type | Individual |
| Full Name | DR. KEVIN RUSSELL MIKALAITIS |
| Practice Address |
1318 Vivian St Longmont CO 80501-3217 |
| Practice Telephone | 3037760882 |
| Practice Fax Number | 3037761053 |
| Mailing Telephone | 3037760882 |
| Mailing Fax Number | 3037761053 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2008-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHR-6064 | CO | Chiropractic Providers |
| Street Address |
1318 VIVIAN ST |
| City | LONGMONT |
| State | CO |
| Zip Code | 80501-3217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912183724 | Align Chiropractic Center, LLC | Chiropractor | 1318 Vivian St, Longmont, CO 80501-3217 | 2008-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376774 | Boulder County Public Health | Public Health or Welfare | 515 Coffman Street, Suite 200, Longmont, CO 80501 | 2020-08-12 |
| 1164032827 | Kidstuff Child and Family Counseling, P.C. | Marriage & Family Therapist | 360 15th Ave, Ste. 104, Longmont, CO 80501 | 2020-08-06 |
| 1861036501 | Stateserv Medical of Colorado | Durable Medical Equipment & Medical Supplies | 63 South Pratt Pkwy, Landmont, CO 80501 | 2019-11-06 |
| 1558915090 | Array Clinical and Therapeutic Services | Assistant Behavior Analyst | 451 21st Ave. Suite B, Longmont, CO 80501 | 2019-08-01 |
| 1275195042 | Alisa Marie Schwegerl | Speech-Language Pathologist | 1800 Stroh Place, Longmont, CO 80501 | 2019-07-02 |
| 1295298545 | Jovahna Pena | Counselor | Behavioral Health Group, 850 23rd Ave Unit A, Longmont, CO 80501 | 2019-04-12 |
| 1659845568 | University Physicians Incorporated | Advanced Practice Midwife | 2030 Mountain View Ave Ste 400, Longmont, CO 80501 | 2019-01-14 |
| 1013404714 | Crafted Physical Therapy Pllc | Physical Therapist | 701 Delaware Ave Unit E, Longmont, CO 80501 | 2018-04-18 |
| 1588110860 | Randall Bonnom | Counselor | 420 21st Ave #113, Longmont, CO 80501 | 2016-08-28 |
| 1225401771 | Sowash Optometry Group, PC | Eyewear Supplier (Equipment, not the service) | 1242 S. Hover Street, Suite C200, Longmont, CO 80501 | 2015-11-05 |
| Find all providers in zip 80501 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043855950 | Hg Wellness LLC | Chiropractor | 1240 Ken Pratt Blvd # 7-3, Longmont, CO 80501-6300 | 2019-11-14 |
| 1437701349 | Carissa Supry | Chiropractor | 829 Main St Ste 6, Longmont, CO 80501-4954 | 2019-07-10 |
| 1629561683 | Kevin Berg | Chiropractor | 1020 Ken Pratt Blvd Unit D, Longmont, CO 80501-6376 | 2018-06-13 |
| 1427478544 | Cameron Richard Nyman | Chiropractor | 2144 Main St Ste 3, Longmont, CO 80501-8403 | 2014-04-16 |
| 1770824310 | Micheal Allen Walker | Chiropractor | 351 Coffman St, Ste 120, Longmont, CO 80501-5457 | 2013-03-06 |
| 1891048484 | Dennis Orvin Thompson | Chiropractor | 5562 Prospect Rd, Longmont, CO 80503-9046 | 2012-10-19 |
| 1760730378 | Carlson Family Chiropractic, PC | Chiropractor | 900 Coffman St Ste D, Longmont, CO 80501-4588 | 2012-08-29 |
| 1669761458 | Mvp Chiropractic | Chiropractor | 2030 Terry St Ste A, Longmont, CO 80501-1889 | 2011-03-31 |
| 1164726303 | Rejuv Health Makeovers | Chiropractor | 742 Tenacity, Unit A, Longmont, CO 80504 | 2011-01-03 |
| 1326341900 | Whitney Reed Carlson | Chiropractor | 438 Terry St, Longmont, CO 80501-5442 | 2010-12-21 |
| Find all providers in LONGMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.