Individual provider Active NPI

Dustin Levi McQueary, DC

  • Chiropractor
  • Columbia, KY
National Provider Identifier
1255894135
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0000 Issued in KY
Practice address
206 Dohoney Trce
Columbia, KY 42728-5532
Phone
(270) 380-1713
Fax
(270) 380-1714
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0000 KY Primary

Addresses

Primary practice location

206 Dohoney Trce
Columbia, KY 42728-5532

Mailing address

206 Dohoney Trce
Columbia, KY 42728-5532
Phone (270) 380-1713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190820003664 KY Practitioner - Chiropractic 6608104294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

206 Dohoney Trce
Suite 2
Columbia, KY 42728-5532
Phone (270) 380-1713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000KYMDTechnician/Technologist
3403TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ridge Chiropractic LLC Chiropractor CurrentSince May 28, 2024 Accepting new patients

Locations

206 Dohoney Trce
Ste 2
Columbia, KY 42728
Phone (270) 380-1713

206 Dohoney Trce
Columbia, KY 42728
Phone (270) 380-1713

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1255894135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 DOHONEY TRCE",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427285532",
            "telephone_number": "270-380-1713",
            "fax_number": "270-380-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 DOHONEY TRCE",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427285532",
            "telephone_number": "270-380-1713",
            "fax_number": "270-380-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUEARY",
        "first_name": "DUSTIN",
        "middle_name": "LEVI",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.