Healthsource of Elizabethtown

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4477 Issued in KY

Legal business name

HEALTHSOURCE OF ELIZABETHTOWN

Practice address

120 Helmwood Plaza Dr
Suite 106
Elizabethtown, KY 42701-2479

Phone

(270) 769-5400

Fax

(270) 769-0567

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Donald R. Casey, D.C.

Title

Owner

Phone

(270) 769-5400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1083890909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 996",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427020996",
            "telephone_number": "270-769-5400",
            "fax_number": "270-769-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HELMWOOD PLAZA DR",
            "address_2": "SUITE 106",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012479",
            "telephone_number": "270-769-5400",
            "fax_number": "270-769-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF ELIZABETHTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-769-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.