Organization Active NPI

McClellan Chiropractic Center, PSC

  • Chiropractor
  • Richmond, KY
National Provider Identifier
1235284787
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3790 Issued in KY
Legal business name
MCCLELLAN CHIROPRACTIC CENTER, PSC
Practice address
1140 Barnes Mill Rd
Richmond, KY 40475-8730
Phone
(859) 623-3780
Fax
(859) 623-8377
NPI assigned
Jan 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John Dallas McClellan, D.C.
Title
Chiropractor
Phone
(859) 623-3780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3790 KY Primary

Addresses

Primary practice location

1140 Barnes Mill Rd
Richmond, KY 40475-8730

Mailing address

1140 Barnes Mill Rd
Richmond, KY 40475-8730
Phone (859) 623-3780

Other identifiers 5

IdentifierTypeStateIssuer
85000669MedicaidKY
P00030494OtherKYRAILROAD RETIREMENT BOARD
6700325OtherKYCIGNA HEALTHCARE
000000271734OtherKYANTHEM
5833098OtherKYAETNA

National Provider Directory

National Provider Directory

Locations

1140 Barnes Mill Rd
Richmond, KY 40475
Phone (859) 623-3780

206 Wayne Dr
#B
Richmond, KY 40475
Phone (859) 623-3780

Practitioners & affiliated clinicians

Practitioners 1

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235284787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 BARNES MILL RD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758730",
            "telephone_number": "859-623-3780",
            "fax_number": "859-623-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BARNES MILL RD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758730",
            "telephone_number": "859-623-3780",
            "fax_number": "859-623-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLELLAN CHIROPRACTIC CENTER, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DALLAS",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "859-623-3780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "3790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85000669",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT BOARD",
            "identifier": "P00030494",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "6700325",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000271734",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5833098",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.