DR. JON R. KRUTAK (NPI# 1033177365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033177365 |
| Entity Type | Individual |
| Full Name | DR. JON R. KRUTAK |
| Credential | D.C. |
| Practice Address |
4924 Fort Henry Dr Suite E Kingsport TN 37663-3386 |
| Practice Telephone | 4232397340 |
| Practice Fax Number | 4232397452 |
| Mailing Telephone | 4232397340 |
| Mailing Fax Number | 4232397452 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2008-03-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC1096 | TN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | RAILROAD MEDICARE | P00441207 | 01 |
| TN | 3676970 | 05 | |
| TN | CIGNA | 4324698 | 01 |
| TN | UNITED HEALTHCARE | TN0102 | 01 |
| TN | BLUE CROSS BLUE SHIELD | 3058747 | 01 |
| TN | JOHN DEERE | TN0104 | 01 |
| Street Address |
4924 FORT HENRY DR SUITE E |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37663-3386 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649528126 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 1567 North Eastman Road, Kingsport, TN 37663 | 2012-08-15 |
| 1548546419 | Vickie R Harris | Counselor | 317 Pitt Road, Kingsport, TN 37663 | 2011-10-24 |
| 1467746446 | Eric A. Echard | Dentist | 1339 Moreland Drive, Suite 1, Kingsport, TN 37663 | 2011-06-07 |
| 1619003399 | Colonial Heights Pharmacy, Inc. | Pharmacy | 4221 Ft. Henry Drive, Kingsport, TN 37663 | 2007-02-26 |
| 1316005986 | Robert F Mcamis Jr. | Dentist | 4016 Fort Henry Drive, Kingsport, TN 37663 | 2006-12-05 |
| 1467567412 | Colonial Heights Dental Assocaites | Dentist | 150 Clinic Drive, Suite A, Kingsport, TN 37663 | 2006-08-20 |
| 1194777953 | Nicholas Brett Smith | Family Medicine | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2006-05-17 |
| 1396720108 | Resp-i-care, Inc. | Durable Medical Equipment & Medical Supplies | 648 Eastern Star Rd, Kingsport, TN 37663 | 2005-12-14 |
| 1023000429 | Darryl Fontaine | Anesthesiology | 4105 Fort Henry Drive, Suite 207, Kingsport, TN 37663 | 2005-08-22 |
| 1659701696 | Jordan Burke | Physician Assistant | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2013-11-12 |
| Find all providers in zip 37663 | ||||
| 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 |
|---|---|---|---|---|
| 1124634126 | Michael Haun | Chiropractor | 2105 E Center St Ste C, Kingsport, TN 37664-2664 | 2020-09-16 |
| 1447676531 | Cheng Eak Chew | Chiropractor | 2020 Meadowview Pkwy Ste 110, Kingsport, TN 37660-7388 | 2014-03-13 |
| 1811252901 | Fulmer Chiropractic, Pllc | Chiropractor | 150 Clinic Dr Ste C, Kingsport, TN 37663-2254 | 2012-07-05 |
| 1356629703 | Shannon Scott Hall | Chiropractor | 1652 Pleasant Ave, Kingsport, TN 37664-3125 | 2011-08-02 |
| 1144411067 | Brett Tyson Salley | Chiropractor | 2313 East Center St, Suite A, Kingsport, TN 37664-2798 | 2007-08-06 |
| 1457435604 | Joseph Frank Amato | Chiropractor | 4012 Fort Henry Dr, Kingsport, TN 37663-2028 | 2006-10-24 |
| 1669553293 | Jerry Allen Price II | Chiropractor | 3901 Fort Henry Dr, Kingsport, TN 37663-2025 | 2006-10-18 |
| 1124112792 | Ava R Carter | Chiropractor | 1567 N Eastman Road, Kingsport, TN 37664 | 2006-10-03 |
| 1487754644 | Bill Haywood Gillenwater | Chiropractor | 1392 E Center St, Kingsport, TN 37664-2445 | 2006-09-25 |
| 1407843634 | Ronald Ernest Chambers | Chiropractor | 205 E Sullivan St, Kingsport, TN 37660-4328 | 2005-10-03 |
| Find all providers in KINGSPORT | ||||
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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.