Kevin James Wadle, DC

Individual provider Active NPI Chiropractor · Taylorsville, KY

NPI 1245226992 · NPPES record last updated Nov 14, 2007

Key facts

NPI
1245226992
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
4328 (KY)
Practice address
101 Settlers Center Rd
Taylorsville, KY 40071-7732
Phone
(502) 477-5000
Fax
(502) 477-5005
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2304 Hurstbourne Village Dr
Suite 100
Louisville, KY 40299-1853

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4328KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Danan L Hall Chiropractic PLLC Chiropractor Past Accepting new patients
Taylorsville Chiropractic, Inc Chiropractor Past
since May 1, 2003
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4328 KY Yes

Addresses

Primary practice location

101 Settlers Center Rd
Taylorsville, KY 40071-7732

Mailing address

101 Settlers Center Rd
Taylorsville, KY 40071-7732
Phone (502) 477-5000

Other identifiers

IdentifierTypeStateIssuer
85043289MedicaidKY
1065686OtherKYPASSPORT

Other providers in Taylorsville, KY

All providers in Taylorsville, KY · Chiropractor in Kentucky

Sources for this page

Verify at the official NPI Registry.