DR. KYLE MATTHEW ELLENSOHN (NPI# 1548543754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548543754 |
| Entity Type | Individual |
| Full Name | DR. KYLE MATTHEW ELLENSOHN |
| Credential | D.C. |
| Practice Address |
6110 Nw 86th St Suite 102 Johnston IA 50131-2257 |
| Mailing Address |
208 S Main St Suite 102 Osceola IA 50213-1416 |
| Practice Telephone | 5152764946 |
| Practice Fax Number | 5152766535 |
| Mailing Telephone | 6413422122 |
| Mailing Fax Number | 6413422119 |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2016-12-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 007424 | IA | Chiropractic Providers |
| Street Address |
6110 NW 86TH ST SUITE 102 |
| City | JOHNSTON |
| State | IA |
| Zip Code | 50131-2257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376947630 | Megan Marie Herrmann | Chiropractor | 6110 Nw 86th St, Suite 102, Johnston, IA 50131-2257 | 2014-10-15 |
| 1194129460 | Eric Herrmann | Chiropractor | 6110 Nw 86th St, #102, Johnston, IA 50131-2257 | 2014-10-15 |
| 1326442690 | Herrmann Family Chiropractic LLC | Chiropractor | 6110 Nw 86th St, #102, Johnston, IA 50131-2257 | 2014-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568011229 | Joseph Barnard | Technician | 6406 Theresa Dr, Johnston, IA 50131 | 2019-09-05 |
| 1073098208 | Heather Nicole Prettyman | Social Worker | 5406 Marle Hay Rd., Johnston, IA 50131 | 2018-10-03 |
| 1982182606 | Dental Studio of Iowa PC | Dentist | 5495 Nw 100th Street, Johnston, IA 50131 | 2018-08-03 |
| 1982063921 | Braincare, LLC | Physiological Laboratory | 6165 Nw 86th St Ste 130, Johnston, IA 50131 | 2016-02-18 |
| 1104293570 | Sarah Michelle Fees | Nurse Practitioner | 8605 Chambery Blvd, Johnston, IA 50131 | 2015-09-01 |
| 1013329978 | Jonathan Jeffrey Karch | Dentist | 5495 Nw 100th St, Johnston, IA 50131 | 2014-05-27 |
| 1053757500 | Patricia L Hart | Social Worker | 6061 Bradford Ln, Johnston, IA 50131 | 2013-05-10 |
| 1205105855 | Lesile Jane Mentele | Pharmacist | 6100 Nw 97th St, Johnston, IA 50131 | 2011-12-27 |
| 1750610812 | Amanda J Moore | Chiropractor | 8671 Northpark Ct, Johnston, IA 50131 | 2009-12-18 |
| 1225293426 | Center for Maximized Living, LLC | Chiropractor | 8671 Northpark Ct., Johnston, IA 50131 | 2008-07-28 |
| Find all providers in zip 50131 | ||||
| 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 |
|---|---|---|---|---|
| 1821659210 | Joshua R Lancellotti | Chiropractor | 1524 Atwood Ave Ste 210a, Johnston, RI 02919-3228 | 2019-06-26 |
| 1598195349 | Walton A Smith | Chiropractor | 101 Slide Hill Rd, Johnston, SC 29832-1359 | 2013-11-14 |
| 1558658641 | Nathan Andrew Hinkeldey | Chiropractor | 5619 Nw 86th St, Suite 400, Johnston, IA 50131-1819 | 2011-07-08 |
| 1043503493 | Carolus Chiropractic & Wellness Center | Chiropractor | 5765 Merle Hay Rd Ste 10, Johnston, IA 50131-2810 | 2011-05-18 |
| 1780901363 | Michael Anthony Pezza | Chiropractor | 1 Harding Ave, Johnston, RI 02919-5010 | 2010-04-22 |
| 1750610812 | Amanda J Moore | Chiropractor | 8671 Northpark Ct, Johnston, IA 50131 | 2009-12-18 |
| 1417180829 | Active Wellness Chiropractic & Rehabilitation, LLC. | Chiropractor | 8711 Windsor Pkwy Ste 7, Johnston, IA 50131-2296 | 2009-09-01 |
| 1922238211 | Aaron Dwight Rector | Chiropractor | 8711 Windsor Pkwy, Suite 7, Johnston, IA 50131-2296 | 2009-07-21 |
| 1225293426 | Center for Maximized Living, LLC | Chiropractor | 8671 Northpark Ct., Johnston, IA 50131 | 2008-07-28 |
| 1720247398 | Schultz Chiropractic Wellness Zone, P.C. | Chiropractor | 5850 Nw 62nd Ave, Johnston, IA 50131-1537 | 2008-06-08 |
| Find all providers in JOHNSTON | ||||
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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.