Active NPI
Primary Injury Care
- Rehabilitation Chiropractor
- Elizabethtown, KY
National Provider Identifier
1265159404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- Legal business name
- PRIMARY INJURY CARE
- Practice address
- 2935 Dolphin Dr Ste 203
Elizabethtown, KY 42701-4112 - Phone
- (270) 900-0157
- NPI assigned
- Oct 27, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Trace Robert Kelly, DC, FNP
- Title
- Owner
- Phone
- (502) 415-3943
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | Primary | ||
| Family Nurse Practitioner | 363LF0000X |
Addresses
Primary practice location
2935 Dolphin Dr Ste 203
Elizabethtown, KY 42701-4112
Mailing address
2935 Dolphin Dr Ste 203
Elizabethtown, KY 42701-4112
Phone (270) 900-0157
Other names 1
- Primary Injury Care and Wellness
National Provider Directory
National Provider DirectoryLocations
2935 Dolphin Dr
Ste 203
Elizabethtown, KY 42701
Phone (270) 737-5921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666828800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666828800000",
"number": "1265159404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2935 DOLPHIN DR STE 203",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427014112",
"telephone_number": "270-900-0157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2935 DOLPHIN DR STE 203",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427014112",
"telephone_number": "270-900-0157"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIMARY INJURY CARE",
"organizational_subpart": "NO",
"enumeration_date": "2022-10-27",
"last_updated": "2022-10-27",
"certification_date": "2022-10-27",
"status": "A",
"authorized_official_last_name": "KELLY",
"authorized_official_first_name": "TRACE",
"authorized_official_middle_name": "ROBERT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "502-415-3943",
"authorized_official_credential": "DC, FNP"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Rehabilitation",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Primary Injury Care and Wellness",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.