Organization Active NPI

Shelby Street Chiropractic & Injury Rehab PSC

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1073817987
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SHELBY STREET CHIROPRACTIC & INJURY REHAB PSC
Practice address
802 E Broadway
Louisville, KY 40204-1053
Phone
(502) 583-8767
Fax
(502) 583-5770
NPI assigned
Jan 6, 2011
Last updated
Jan 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Authorized official

Name
Michael Clover
Title
Chiropractor
Phone
(502) 386-1594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

802 E Broadway
Louisville, KY 40204-1053

Mailing address

802 E Broadway
Louisville, KY 40204-1053
Phone (502) 583-8767

National Provider Directory

National Provider Directory

Locations

802 E Broadway
Louisville, KY 40204
Phone (502) 583-8767

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1073817987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 E BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041053",
            "telephone_number": "502-583-8767",
            "fax_number": "502-583-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 E BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041053",
            "telephone_number": "502-583-8767",
            "fax_number": "502-583-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY STREET CHIROPRACTIC & INJURY REHAB PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-06",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "CLOVER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "502-386-1594"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.