DR. KELLY JAY KADOLPH D.C.
NPI 1639114366
Chiropractor - Sports Physician in Bethany, MO

Q: What is Kelly Kadolph's NPI number?

The NPI number for Kelly Kadolph is 1639114366. It was assigned to this individual provider in the NPPES registry on June 17, 2006.

Q: What is Kelly Kadolph's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Kadolph was last updated on January 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 17, 2006

3307 MILLER ST, BETHANY, MO 64424(660) 425-3312(660) 425-3438 Get Directions Write a Review

NPPES record last updated: January 16, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Kelly Jay Kadolph D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY JAY KADOLPH D.C. (NPI 1639114366) is an individual sports physician in Bethany, Missouri, licensed in Missouri (005205) and active in the NPI registry since June 2006. He is a graduate of Cleveland Chiropractic College - Kansas City (1985).

NPPES Registry Identity

NPI1639114366

Entity TypeIndividualMale

Primary Taxonomy111NS0005X

Provider Legal NameDR. KELLY JAY KADOLPHCredential: D.C.

Location Address3307 MILLER STBethany, MO 64424-2716

Mailing AddressPo Box 527Bethany, MO 64424-0527 · (660) 425-3312 · Fax (660) 425-3438

Phone(660) 425-3312

Fax(660) 425-3438

Sole ProprietorYes

Medical School CMSCleveland Chiropractic College - Kansas CityGraduated 1985

Enumeration DateJune 17, 2006

Last NPPES UpdateJanuary 16, 2014

✔ NPI 1639114366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers

Taxonomy Code111NS0005X

License✔ Licensed in MO · 005205

Definition

A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.

3307 MILLER ST, Bethany, MO 64424

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Other Identifiers 3

Other20768013MO · Blue Cross Blue Shield

Medicare ID-Type Unspecified0005766MO

Medicare UPINT42399MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly Jay Kadolph D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9234290891

PECOS Enrollment IDI20081202000248

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Kadolph's NPI number?

The NPI number for Kelly Kadolph is 1639114366. It was assigned to this individual provider in the NPPES registry on June 17, 2006.

Where is Kelly Kadolph located?

Kelly Kadolph practices at 3307 Miller St, Bethany, MO 64424. The listed phone number is (660) 425-3312.

What is Kelly Kadolph's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Kelly Kadolph enrolled in Medicare?

Yes. Kelly Kadolph is registered in the Medicare PECOS enrollment system.

What insurance does Kelly Kadolph accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 5 other insurers list Kelly Kadolph as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Kadolph was last updated on January 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.