Physician Compare National (NPI:1275625030)

HEALTHCARE PROVIDER: KENN E IVERSON DC PC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1275625030
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1153319603
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040504000087
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	IVERSON
	Individual professional last name
Provider First Name	KENN
	Individual professional first name
Provider Middle Name	EDWARD
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DC
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	NORTHWESTERN COLLEGE OF CHIROPRACTIC
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	312 2ND AVE SW
	Group Practice or individual's line 1 address
City	JAMESTOWN
	Group Practice or individual's city
State	ND
	Group Practice or individual's state
Zip Code	584014177
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y