Organization Active NPI

Valley Chiropractic Center, PSC

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1063469161
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4168 Issued in KY
Legal business name
VALLEY CHIROPRACTIC CENTER, PSC
Practice address
3910 E Pages LN
Louisville, KY 40272-2669
Phone
(502) 937-4481
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Authorized official

Name
Donald Paul Eldridge, D.C.NPI 1649213372
Title
President
Phone
(502) 937-4481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4168 KY Primary

Addresses

Primary practice location

3910 E Pages LN
Louisville, KY 40272-2669

Mailing address

3910 E Pages LN
Louisville, KY 40272-2669
Phone (502) 937-4481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050519000831 KY Part B Supplier - Clinic/Group Practice 2264473248 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

3910 E Pages Ln
Louisville, KY 40272
Phone (502) 937-4481

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402617600000",
    "number": "1063469161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 E PAGES LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402722669",
            "telephone_number": "502-937-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 E PAGES LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402722669",
            "telephone_number": "502-937-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CHIROPRACTIC CENTER, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2014-06-13",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-937-4481",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4168",
            "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 Jun 13, 2014; 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.