Individual provider Active NPI

Jack Edward Gallagher, DC

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1023673068
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
263347 Issued in KY
Practice address
7707 Preston Hwy
Louisville, KY 40219-3138
Phone
(502) 962-2277
Fax
(502) 962-1001
NPI assigned
May 6, 2019
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 263347 KY Primary

Addresses

Primary practice location

7707 Preston Hwy
Louisville, KY 40219-3138

Mailing address

7200 W 141St St Apt 2501
Overland Park, KS 66223-3978
Phone (231) 409-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200910001357 KY Practitioner - Chiropractic 7618399379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Martin Chiropractic Group, PSCGroup PAC ID 2264517473, 3 clinicians

Practice addresses (Care Compare)

138 Evergreen Rd
Suite 102
Louisville, KY 40243-1410
Phone (502) 489-8480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
263347KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Chiropractic Group, PSC Chiropractor CurrentSince Nov 28, 2022 Accepting new patients
Astra Performance Health LLC PastSince May 16, 2021 Accepting new patients

Locations

138 Evergreen Rd
Ste 102
Louisville, KY 40243
Phone (502) 245-3599

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1023673068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 W 141ST ST APT 2501",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233978",
            "telephone_number": "231-409-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7707 PRESTON HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193138",
            "telephone_number": "502-962-2277",
            "fax_number": "502-962-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "JACK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-06",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "263347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.