Organization Active NPI

Primary Injury Care

  • Rehabilitation Chiropractor
  • Elizabethtown, KY
National Provider Identifier
1265159404
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
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

Updated by the provider on Oct 27, 2022

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)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NR0400X Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.