DR. KRYSTIN JADE PROVO (NPI# 1598100448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598100448 |
| Entity Type | Individual |
| Full Name | DR. KRYSTIN JADE PROVO |
| Credential | D.C |
| Practice Address |
112 E 17th St Ottawa KS 66067-3800 |
| Practice Telephone | (785) 242-9393 |
| Practice Fax Number | 9135382289 |
| Mailing Telephone | 7852429393 |
| Mailing Fax Number | 9135382289 |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2018-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 01-05533 | KS | Chiropractic Providers |
| Street Address |
112 E 17TH ST |
| City | OTTAWA |
| State | KS |
| Zip Code | 66067-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689675704 | Brent L Kesler | Chiropractor | 112 E 17th St, Ottawa, KS 66067-3800 | 2005-08-10 |
| 1538698485 | Allegiant Health and Laser | Chiropractor | 112 E 17th St, Ottawa, KS 66067-3800 | 2017-06-05 |
| 1245673680 | Chad James Welter | Chiropractor | 112 E 17th St, Ottawa, KS 66067-3800 | 2013-04-16 |
| 1447520549 | Weston E Zenner | Chiropractor | 112 E 17th St, Ottawa, KS 66067-3800 | 2012-01-05 |
| 1053556589 | Kevin Joseph Cook | Chiropractor | 112 E 17th St, Ottawa, KS 66067-3800 | 2008-12-12 |
| 1336237379 | Franklin County Chiropractic Pa | Chiropractor | 112 E 17th St, Ottawa, KS 66067-3800 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482870 | Katie Jean Turpin | Occupational Therapist | 3901 S Main St, Ottawa, KS 66067 | 2020-03-18 |
| 1619526464 | Jennifer Raybern | Specialist/Technologist | 1001 S Cedar St, Ottawa, KS 66067 | 2019-09-04 |
| 1508419938 | Custom Dental of Ottawa, Pa | Clinic/Center | 2030 S Princeton St, Ottawa, KS 66067 | 2019-07-24 |
| 1861948507 | Jeffrey Byrne Kelley | Pharmacist | 2101 S Princeton Rd, Ottawa, KS 66067 | 2016-09-01 |
| 1619185188 | Vintage Park At Ottawa LLC | Assisted Living Facility | 2250 S Elm St, Ottawa, KS 66067 | 2007-05-18 |
| 1356423495 | Ottawa Oral Surgery Lc | Dentist | 107 E 23rd St, Ste 3 Ottawa Oral Surgery Lc, Ottawa, KS 66067 | 2006-10-19 |
| 1669564332 | Sandra K Staneart | Nurse Practitioner | 1302 South Main St, Suite 1, Ottawa, KS 66067 | 2006-09-29 |
| 1467553214 | Nancy L Pauw | Social Worker | 2476 Reno Rd, Ottawa, KS 66067 | 2006-09-26 |
| 1700847043 | T.a. Rainbolt, Dds, P.a. | Dentist | 1334 S. Main Street, Ottawa, KS 66067 | 2006-03-28 |
| 1659341634 | Milton Laverne Sampson | Nurse Anesthetist, Certified Registered | 1301 S Main, Ottawa, KS 66067 | 2006-01-24 |
| Find all providers in zip 66067 | ||||
| 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 |
|---|---|---|---|---|
| 1841840576 | Tanner Christensen Chiropractic LLC | Chiropractor | 343 W 23rd St Ste 4, Ottawa, KS 66067-9502 | 2019-09-15 |
| 1699252841 | Casanova Chiropractic LLC | Chiropractor | 417 Cornell St, Ottawa, IL 61350-3819 | 2018-07-20 |
| 1154844785 | Nicole Olechowicz | Chiropractor | 1880 N Perry St Ste 300, Ottawa, OH 45875-1177 | 2017-07-25 |
| 1194145466 | Dr. Hill Chiropractic Clinic, S.c. | Chiropractor | 436 2nd Ave, Ottawa, IL 61350-3610 | 2014-04-24 |
| 1760816854 | Ottawa Chiropractic | Chiropractor | 1001 Clinton St, Ottawa, IL 61350-2039 | 2013-08-26 |
| 1881939957 | Jeffrey Michael Gage | Chiropractor | 1602 Illinois Ave, Ottawa, IL 61350-3236 | 2012-11-30 |
| 1124329172 | Donald J. Schmidt, D.c. Inc. | Chiropractor | 139 S. Walnut St., Ottawa, OH 45875 | 2010-11-08 |
| 1124275441 | Gary N Rowley | Chiropractor | 1280 Phelps St, Ottawa, IL 61350-3277 | 2008-08-19 |
| 1922287093 | Byron L. Perry Dc PC Inc | Chiropractor | 111 E Canal Ave, Ottawa, IL 61350-2111 | 2007-10-25 |
| 1467647107 | Michael W Oliver | Chiropractor | 225 S Walnut St, Ottawa, KS 66067-2247 | 2007-09-06 |
| Find all providers in OTTAWA | ||||
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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.