NPIMap

Organization Active NPI

Chiropractic Rehabilitation & Injury Clinic Inc

  • Chiropractor
  • Paducah, KY
National Provider Identifier
1235272535
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4905 Issued in KY
Legal business name
CHIROPRACTIC REHABILITATION & INJURY CLINIC INC
Practice address
2402 New Holt Rd
Paducah, KY 42001-7455
Phone
(270) 534-0920
Fax
(270) 534-4024
NPI assigned
Feb 15, 2007
Last updated
Oct 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Authorized official

Name
Dr. Samuel Kent Clark, DCNPI 1811903800
Title
Owner
Phone
(270) 534-0920

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4905 KY Primary

Addresses

Primary practice location

2402 New Holt Rd
Paducah, KY 42001-7455

Mailing address

2402 New Holt Rd
Paducah, KY 42001-7455
Phone (270) 534-0920

National Provider Directory

National Provider Directory

Locations

2402 New Holt Rd
Paducah, KY 42001
Phone (270) 534-0920

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1235272535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017455",
            "telephone_number": "270-534-0920",
            "fax_number": "270-534-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017455",
            "telephone_number": "270-534-0920",
            "fax_number": "270-534-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC REHABILITATION & INJURY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-534-0920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.