1013962950 NPI number — MR. CHRISTOPHER D KINSLOW PT, DC

Table of content: MR. CHRISTOPHER D KINSLOW PT, DC (NPI 1013962950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013962950 NPI number — MR. CHRISTOPHER D KINSLOW PT, DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KINSLOW
Provider First Name:
CHRISTOPHER
Provider Middle Name:
D
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PT, DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013962950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
208 WALNUT STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-812-8262
Provider Business Mailing Address Fax Number:
816-640-0135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18215 STATE RT 45 N
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
WESTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-812-8262
Provider Business Practice Location Address Fax Number:
816-386-9911
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2005032878 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 119374 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10001822600 . This is a "CHP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 10001852100 . This is a "CHP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 693312 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: T80D030 . This is a "MEDICARE DC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 693016 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 32827028 . This is a "BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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