Gladish Chiropractic and Acupuncture LLC
Organization Active NPI Chiropractor · Tell City, IN
NPI 1114596152 · NPPES record last updated Jun 23, 2021
Key facts
- NPI
- 1114596152
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- GLADISH CHIROPRACTIC AND ACUPUNCTURE LLC
- Practice address
- 1430 Main St
Tell City, IN 47586-1404 - Phone
- (812) 547-8692
- Fax
- (812) 547-8694
- NPI assigned
- Jun 23, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Jared Lee Gladish, DC
- Title
- Owner
- Phone
- (812) 547-8692
Practitioners 2
-
Jared L Gladish, DC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2324522 | Gladish Chiropractic and Acupuncture, LLC | Certificate of waiver | May 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210716000418 | IN | Part B Supplier - Clinic/Group Practice | 1557763356 |
Receives reassigned benefits from 2 practitioners Practice locations: Tell City, IN |
National Provider Directory
Locations
1430 Main St
Tell City, IN 47586
Phone (812) 547-8692
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
1430 Main St
Tell City, IN 47586-1404
Mailing address
1430 Main St
Tell City, IN 47586-1404
Phone (812) 547-8692
Other providers in Tell City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.