Organization Active NPI

Precision Chiropractic Center, PSC

  • Chiropractor
  • Stanford, KY
National Provider Identifier
1104015593
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4607 Issued in KY
Legal business name
PRECISION CHIROPRACTIC CENTER, PSC
Practice address
109 Lily Dr.
Stanford, KY 40484
Phone
(606) 365-0203
Fax
(606) 365-0208
NPI assigned
Oct 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Authorized official

Name
Dr. Stanley Skipper, D.C.
Title
President/Doctor
Phone
(606) 365-0203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4607 KY Primary

Addresses

Primary practice location

109 Lily Dr.
Stanford, KY 40484

Mailing address

109 Lily Dr.
Stanford, KY 40484
Phone (606) 365-0203

Other identifiers 1

IdentifierTypeStateIssuer
85001279MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041207000827 KY Part B Supplier - Clinic/Group Practice 5496711848 Receives reassigned benefits from 1 practitioner
Practice locations: Stanford, KY

National Provider Directory

National Provider Directory

Locations

109 Lily St
Stanford, KY 40484
Phone (606) 365-0203

123 Frontier Blvd
Ste 1
Stanford, KY 40484
Phone (859) 236-6994

Practitioners & affiliated clinicians

Practitioners 1

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": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1104015593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LILY DR.",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "40484",
            "telephone_number": "606-365-0203",
            "fax_number": "606-365-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LILY DR.",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "40484",
            "telephone_number": "606-365-0203",
            "fax_number": "606-365-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION CHIROPRACTIC CENTER, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "SKIPPER",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT/DOCTOR",
        "authorized_official_telephone_number": "606-365-0203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85001279",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.