=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740477330
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHIROKEI CONSULTING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2007
-----------------------------------------------------
Last Update Date | 11/09/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2300 GOOD HOPE RD SE APT 916
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20020-5132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-744-3430
-----------------------------------------------------
Fax | 202-536-2478
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 30276
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20030-0276
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-744-3430
-----------------------------------------------------
Fax | 202-536-2478
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. KEITA VANTERPOOL
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 202-744-3430
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NI0013X
-----------------------------------------------------
Taxonomy Name | Independent Medical Examiner Chiropractor
-----------------------------------------------------
License Number | S03383
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH30018
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------