Bradley a. Tack P.S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BRADLEY A. TACK P.S.C.

Practice address

5131 US Highway 62
Calvert City, KY 42029-8390

Phone

(270) 395-4540

Fax

(270) 395-7715

NPI assigned

Jan 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bradley A. Tack, D.C.NPI 1386645737

Title

Owner

Phone

(270) 395-4540

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Calvert City Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley A Tack, D.C.

  • Chiropractor
  • Calvert City, KY
  • NPI 1386645737
  Medicare reassignment Care Compare group NPD Authorized official
• Lisa A Tack, D.C.

  • Chiropractor
  • Calvert City, KY
  • NPI 1619978129
  Medicare reassignment Care Compare group NPD
• Charles Epstein, D.C.

  • Chiropractor
  • Calvert City, KY
  • NPI 1316948839
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003969460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5131 US HIGHWAY 62",
            "city": "CALVERT CITY",
            "state": "KY",
            "postal_code": "420298390",
            "telephone_number": "270-395-4540",
            "fax_number": "270-395-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 US HIGHWAY 62",
            "city": "CALVERT CITY",
            "state": "KY",
            "postal_code": "420298390",
            "telephone_number": "270-395-4540",
            "fax_number": "270-395-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY A. TACK P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TACK",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-395-4540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85900181",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calvert City Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sunetta Barrett
• Whitney A Berry
• Biokinetics Inc.
• Biokinetics, Inc
• Kimberly Blackburn
• Calvert City Convalescent Center, Inc
• Heather Abigail Carlton, PTA
• Clarkson Optometry Midwest Inc.
• Richard Nicholas Cocke, DMD
• Lauren Renee Coomer

• All providers in Calvert City, KY
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.