CUSTOM CHIROPRACTIC CENTER LLC (NPI# 1659562148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659562148 |
| Entity Type | Organization |
| Organization Name | CUSTOM CHIROPRACTIC CENTER LLC |
| Practice Address |
6220 Antioch Rd Suite 200 Shawnee Mission KS 66202-2866 |
| Practice Telephone | 9137221113 |
| Practice Fax Number | 9137222677 |
| Mailing Telephone | 9137221113 |
| Mailing Fax Number | 9137222677 |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | DR. ARVIL LONNIE RUDD (PRESIDENT) |
| Authorized Official Telephone | 9137221113 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 01-04887 | KS | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 33911023 | 01 | |
| KS | RAILROAD MEDICARE | P00220339 | 01 |
| Street Address |
6220 ANTIOCH RD SUITE 200 |
| City | SHAWNEE MISSION |
| State | KS |
| Zip Code | 66202-2866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396832812 | Arvil Lonnie Rudd | Chiropractor | 6220 Antioch Rd, Ste 200, Shawnee Mission, KS 66202-5107 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245863224 | Megan O'rear | Physical Therapist | 6907 Shawnee Mission Parkway, Ste. 207, Overland Park, KS 66202 | 2020-02-18 |
| 1114558194 | Erika Lynne Cool | Advanced Practice Midwife | 6131 Terrydale St., Merriam, KS 66202 | 2020-01-29 |
| 1215568464 | Andreas P Warren | Technician | 5100 Foxridge Dr. Apt 1524, Mission, KS 66202 | 2020-01-27 |
| 1831736099 | Lida Rose Keller | Registered Nurse | 6907 Shawnee Mission Parkway, Suite 207, Overland Park, KS 66202 | 2019-12-06 |
| 1215586235 | Stacy Grabowski | Physical Therapist | 6907 Shawnee Mission Pkwy, Ste. 207, Overland Park, KS 66202 | 2019-09-11 |
| 1932582566 | David Christian Murphy | Internal Medicine | 5030 Glenwood Dr., Mission, KS 66202 | 2015-07-01 |
| 1043609068 | Matthew M Christopher | Physical Therapy Assistant | 6616 Santa Fe Dr, Overland Park, KS 66202 | 2015-01-14 |
| 1710385786 | Tiffany Lorraine Eckland | Occupational Therapist | 8115 Shawnee Mission Parkway, Ste. #100, Merriam, KS 66202 | 2014-12-08 |
| 1720490261 | Antioch Dentistry Pa | Dentist | 5750 Antioch Road, Merriam, KS 66202 | 2014-06-02 |
| 1730529710 | Sierra Lynn Wright | Social Worker | 6000 Lamar Avenue, Suite 130, Mission, KS 66202 | 2013-07-05 |
| Find all providers in zip 66202 | ||||
| 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 |
|---|---|---|---|---|
| 1093105439 | Kaitlin Lavigne | Chiropractor | 10000 W 75th St Ste 117, Shawnee Mission, KS 66204-2241 | 2015-01-23 |
| 1598894479 | Roger Thomas Maher | Chiropractor | 7031 Johnson Dr, Shawnee Mission, KS 66202-2324 | 2007-03-05 |
| 1396832812 | Arvil Lonnie Rudd | Chiropractor | 6220 Antioch Rd, Ste 200, Shawnee Mission, KS 66202-5107 | 2006-10-06 |
| 1760806301 | Healthy Life Chiropractic LLC | Chiropractor | 7410 Switzer St, Shawnee Mission, KS 66203-4550 | 2014-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689359 | Andrew L Todd | Chiropractor | 6800 W 91st St, Overland Park, KS 66212-1453 | 2020-11-02 |
| 1386251924 | Beckley Chiropractic, Inc. | Chiropractor | 2348 Sw Topeka Blvd Ste 202, Topeka, KS 66611-1286 | 2020-09-28 |
| 1073128583 | Jaccard Chiropractic, P.a. | Chiropractor | 4 South 1st Street, #c, Louisburg, KS 66053 | 2020-09-11 |
| 1336752591 | Johnathan Chase Carlin | Chiropractor | 10985 Cody St Ste 100, Overland Park, KS 66210-1219 | 2020-08-27 |
| 1104442193 | Breanna Kay Bezona | Chiropractor | 13830 Sante Fe Trail Dr., St. 104, Lenexa, KS 66215 | 2020-06-25 |
| 1568083129 | Chase Blaha | Chiropractor | 3230 Kimball Ave, Manhattan, KS 66503-2157 | 2020-05-05 |
| 1538780465 | Joshua Whitmore | Chiropractor | 12101 W 110th St Ste 200, Overland Park, KS 66210-3935 | 2020-05-01 |
| 1871127985 | Katie Marie Muller | Chiropractor | 9621 W 87th St, Overland Park, KS 66212-4570 | 2020-02-27 |
| 1265062848 | Kylan Cris Bennett | Chiropractor | 2605 Central Ave, Dodge City, KS 67801-6210 | 2020-01-22 |
| 1932748282 | Jessica Langel | Chiropractor | 7418 W 121st St, Overland Park, KS 66213-1203 | 2020-01-04 |
| Find all providers with the same taxonomy | ||||
| City | SHAWNEE MISSION |
| Zip Code | 66202 |
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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.