Premier Chiropractic Downtown LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3776 Issued in KY

Legal business name

PREMIER CHIROPRACTIC DOWNTOWN LLC

Practice address

2137 Dixie Hwy
Louisville, KY 40210-2242

Phone

(502) 561-0490

Fax

(502) 409-4964

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Allen Green, D.C.

Title

Chiropractor

Phone

(502) 561-0490

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1164631958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7716 BARBOUR PLACE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412730",
            "telephone_number": "502-561-0490",
            "fax_number": "502-409-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402102242",
            "telephone_number": "502-561-0490",
            "fax_number": "502-409-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CHIROPRACTIC DOWNTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "502-561-0490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "3776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2623859000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50008078",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000051525",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85001758",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Louisville, KY
• Providers in Louisville, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.