MEDICARE: DAVID J. VON KERENS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	886	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	350012724	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11922	OTHER	NE	MIDLANDS CHOICE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	47099280	OTHER		MUTUAL OF OMAHA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	09685NE	OTHER	NE	BLUECROSS/BLUESHIELD

General Provider Information

NPI Number	:	1861467383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J. VON KERENS DC

Provider Business Mailing Address
First Line	:	11314 Q ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-3679
Country	:	US
Telephone Number	:	402-592-3060
Fax Number	:	402-592-3363

Provider Business Practice Location Address
First Line	:	11314 Q ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-3679
Country	:	US
Telephone Number	:	402-592-3060
Fax Number	:	402-592-3363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2006
Last Update Date	:	12/07/2010

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Directions to “ DAVID J. VON KERENS DC” Practice Location

Language	Start Address	Practice Location

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