Organization Active NPI

Miller Chiropractic Centre Inc PSC

  • Chiropractor
  • Winchester, KY
National Provider Identifier
1225251366
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3869 Issued in KY
Legal business name
MILLER CHIROPRACTIC CENTRE INC PSC
Practice address
1200 Bypass Rd
Ste B
Winchester, KY 40391-2724
Phone
(859) 744-3700
Fax
(859) 744-3262
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Authorized official

Name
Mark Darryl Miller, D.C.NPI 1073579579
Title
President
Phone
(859) 744-3700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3869 KY Primary

Addresses

Primary practice location

1200 Bypass Rd
Ste B
Winchester, KY 40391-2724

Mailing address

1200 Bypass Rd
Ste B
Winchester, KY 40391-2724
Phone (859) 744-3700

Other identifiers 7

IdentifierTypeStateIssuer
4596OtherKYCHA
NA150329MedicaidKY
607451OtherKYACN
5504456OtherKYAETNA
4400065OtherKYUNITED HEALTH CARE
350029303OtherKYRAIL ROAD MEDICARE
000000062838OtherKYANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080723000785 KY Part B Supplier - Clinic/Group Practice 1052484094 Receives reassigned benefits from 1 practitioner
Practice locations: Winchester, KY

National Provider Directory

National Provider Directory

Locations

1200 Bypass Rd
Ste B
Winchester, KY 40391
Phone (606) 744-3700

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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1225251366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BYPASS RD",
            "address_2": "STE B",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912724",
            "telephone_number": "859-744-3700",
            "fax_number": "859-744-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BYPASS RD",
            "address_2": "STE B",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912724",
            "telephone_number": "859-744-3700",
            "fax_number": "859-744-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER CHIROPRACTIC CENTRE INC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DARRYL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-744-3700",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "3869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "4596",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA150329",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "607451",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5504456",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "4400065",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "350029303",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000062838",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.