Active NPI
Gary Allen Kovalsky, D.C.
- Chiropractor
- West Memphis, AR
National Provider Identifier
1013076165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 15631
- Practice address
- 620 W Broadway , Ste 6
West Memphis, AR 72301 - Phone
- (870) 732-3355
- Fax
- (870) 732-3356
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 15631 | AR | Primary |
Addresses
Primary practice location
620 W Broadway , Ste 6
West Memphis, AR 72301
Mailing address
620 W Broadway St
West Memphis, AR 72301-2907
Phone (870) 732-3355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15631 | AR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Chiropractic #7, PLLC | Chiropractor | Past | Accepting new patients |
| Daryll G. Marshall-Inman DC Inc. | Chiropractor | Past | Accepting new patients |
| Leshaw Chiropractic PLLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397174400000",
"number": "1013076165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 W BROADWAY ST",
"city": "WEST MEMPHIS",
"state": "AR",
"postal_code": "723012907",
"telephone_number": "870-732-3355",
"fax_number": "870-732-3356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 W BROADWAY , STE 6",
"city": "WEST MEMPHIS",
"state": "AR",
"postal_code": "72301",
"telephone_number": "870-732-3355",
"fax_number": "870-732-3356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOVALSKY",
"first_name": "GARY",
"middle_name": "ALLEN",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2014-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "15631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Memphis, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.