Organization Active NPI

Martin Chiropractic Group, PSC

Doing business as Louisville Chiropractic

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1275745861
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4899 Issued in KY
Legal business name
MARTIN CHIROPRACTIC GROUP, PSC
Doing business as
Louisville Chiropractic
Practice address
138 Evergreen Rd
Ste 102
Louisville, KY 40243-1410
Phone
(502) 489-8480
NPI assigned
May 4, 2007
Last updated
Nov 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Authorized official

Name
Dr. Shawn Patrick Martin, D.C.NPI 1609904937
Title
Chiropractor and President
Phone
(502) 489-8480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4899 KY Primary

Addresses

Primary practice location

138 Evergreen Rd
Ste 102
Louisville, KY 40243-1410

Mailing address

138 Evergreen Rd
Ste 102
Louisville, KY 40243-1410
Phone (502) 489-8480

Other names 1

  • Louisville Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080312000523 KY Part B Supplier - Clinic/Group Practice 2264517473 Receives reassigned benefits from 3 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

115 Blankenbaker Pkwy
Louisville, KY 40243
Phone (502) 489-8480

11509 Shelbyville Rd
Louisville, KY 40243
Phone (502) 244-2834

138 Evergreen Rd
Ste 102
Louisville, KY 40243
Phone (502) 245-3599

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1275745861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 EVERGREEN RD",
            "address_2": "STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431410",
            "telephone_number": "502-489-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 EVERGREEN RD",
            "address_2": "STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431410",
            "telephone_number": "502-489-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN CHIROPRACTIC GROUP, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "CHIROPRACTOR AND PRESIDENT",
        "authorized_official_telephone_number": "502-489-8480",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisville Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.