KYLE ANDREW KOENKE (NPI# 1497815575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497815575 |
| Entity Type | Individual |
| Full Name | KYLE ANDREW KOENKE |
| Credential | D.C. |
| Practice Address |
1066 N Power Rd Ste 104 Mesa AZ 85205-5709 |
| Practice Telephone | 4808307288 |
| Practice Fax Number | 4809857255 |
| Mailing Telephone | 4808307288 |
| Mailing Fax Number | 4809857255 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
7157 | AZ | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | RRBCBS | RRP00086254 | 01 |
| AZ | BCBS | AZ0943870 | 01 |
| Street Address |
1066 N POWER RD STE 104 |
| City | MESA |
| State | AZ |
| Zip Code | 85205-5709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982168027 | Sarah Goodman | Physical Therapist | 1066 N Power Rd Ste 104, Mesa, AZ 85205-5709 | 2019-01-23 |
| 1154855088 | Cornerstone Wellness Center LLC | Chiropractor | 1066 N Power Rd Ste 104, Mesa, AZ 85205-5709 | 2017-04-18 |
| 1528242310 | Koenke Chiropractic, Inc. | Chiropractor | 1066 N Power Rd Ste 104, Mesa, AZ 85205-5709 | 2007-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083130199 | Rose Campbell | Technician/Technologist | 649 North Orlando, Mesa, AZ 85205 | 2017-08-21 |
| 1528459781 | Elizabeth Sadler | Nurse Practitioner | 4434 E Brown Rd Ste 102, Mesa, AZ 85205 | 2015-02-10 |
| 1326444324 | Katherine G Perez | Counselor | 152 N Power Rd Ste 2, Mesa, AZ 85205 | 2014-11-18 |
| 1831500800 | C.b.o Hearing | Hearing Aid Equipment | 4406 E. Main St, Suite 103, Mesa, AZ 85205 | 2014-05-13 |
| 1699195107 | Amanda Mcdaniel | Occupational Therapist | 5911 E. Fountain St., Mesa, AZ 85205 | 2014-04-23 |
| 1952640278 | Medstar Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 3932 E Fairfield Cir, Mesa, AZ 85205 | 2013-02-06 |
| 1245575398 | Fabulous Smiles of Mesa | Dentist | 4434 E. Brown Rd, Ste 104, Mesa, AZ 85205 | 2012-11-30 |
| 1992087639 | Matthew Robert Millward | Pharmacist | 1935 N. Power Rd, Mesa, AZ 85205 | 2011-09-19 |
| 1740596733 | Arizona Family & Geriatric Medicine Pllc | Clinic/Center | 5602 E. Main St., Mesa, AZ 85205 | 2010-08-27 |
| 1295049609 | Thomas Chambers | Podiatrist | 5520 E Main St Ste 2, Mesa, AZ 85205 | 2010-07-28 |
| Find all providers in zip 85205 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063588739 | Jeffrey Richard Banas | Chiropractor | 4540 E Baseline Rd Ste 106, Mesa, AZ 85206-4616 | 2006-11-27 |
| 1063436962 | Jose Antonio Rodriguez | Chiropractor | 2509 S Power Rd, #115, Mesa, AZ 85209-6695 | 2006-07-26 |
| 1528242310 | Koenke Chiropractic, Inc. | Chiropractor | 1066 N Power Rd Ste 104, Mesa, AZ 85205-5709 | 2007-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265855647 | Zackery Allen Conklin | Chiropractor | 2929 N 75th Ave Ste 15, Phoenix, AZ 85033-5443 | 2014-01-21 |
| 1275878308 | Brandon Lee Boothe | Chiropractor | 7645 E Evans Rd Ste 140, Scottsdale, AZ 85260-3492 | 2012-11-29 |
| 1417291196 | Sean David Drake | Chiropractor | 3260 N Hayden Rd Ste 111, Scottsdale, AZ 85251-6650 | 2012-11-19 |
| 1205180684 | Natasha Williams | Chiropractor | 8910 N Central Ave, Phoenix, AZ 85020-2819 | 2012-11-06 |
| 1831448869 | Maynard Chiropractic & Wellness Center Inc | Chiropractor | 1920 North Scottsdale Rd, Scottsdale, AZ 85257 | 2012-09-06 |
| 1285902585 | Flp Better Chiropractic LLC | Chiropractor | 2470 S Val Vista Dr Ste 104, Gilbert, AZ 85295-1693 | 2011-12-01 |
| 1790926293 | Maximum Mobility Chiropractic, Inc | Chiropractor | 70 N Mcclintock Dr, Chandler, AZ 85226-3711 | 2009-03-12 |
| 1588814842 | Arizona Spine and Sports Medicine, Pllc | Chiropractor | 17606 N 17th Pl, Unit 1010, Phoenix, AZ 85022-2136 | 2008-09-23 |
| 1598911604 | Kendra A Wellman | Chiropractor | 4646 E Greenway Rd Ste 104, Phoenix, AZ 85032-4805 | 2008-08-09 |
| 1306005590 | A H Chiropractic & Wellness LLC. | Chiropractor | 6360 E Thomas Rd Ste 218, Scottsdale, AZ 85251-7054 | 2008-06-03 |
| Find all providers with the same taxonomy | ||||
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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.