Phaup Chiropractic Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

5477 Issued in KY

Legal business name

PHAUP CHIROPRACTIC CENTER, LLC

Practice address

1015 College Dr
Madisonville, KY 42431-9189

Phone

(270) 452-2187

NPI assigned

Jan 8, 2018

Organization subpart

No

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

Authorized official

Name

Amber Long

Title

Office Manager

Phone

(270) 452-2187

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle Phaup, D.C.

  • Chiropractor
  • Henderson, KY
  • NPI 1578935920
  Medicare reassignment
• Mary Selena Phaup

  • Physical Therapist
  • Madisonville, KY
  • NPI 1558551150
  NPD (past)

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1245747674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 COLLEGE DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319189",
            "telephone_number": "270-452-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 COLLEGE DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319189",
            "telephone_number": "270-452-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAUP CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-452-2187"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "KY",
            "license": "5477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1578935920",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter J.D. (Deon) Perkins, MD
• Kristen Noele Petersen, APRN
• Anthony Petroff, CRNA
• Russell E Peyton, NP
• Sarah Ruth Peyton, FNP
• Phaup Physical Therapy, LLC
• Mary Selena Phaup
• Candida Phelps
• Charles D Phelps, RN
• Susan Lynn Phelps, M.S.

• Clinic/Center in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.