Nicholas A Hasenfratz, DC
Individual provider Active NPI Chiropractor · Poducah, KY
NPI 1306160221 · NPPES record last updated Feb 16, 2016
Key facts
- NPI
- 1306160221
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5455 (KY)
- Practice address
- 2725 James Sanders Blvd.
Suite a
Poducah, KY 42001-8401 - Phone
- (270) 554-5114
- Fax
- (270) 554-5021
- NPI assigned
- Mar 22, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5455 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway City Chiropractic | Chiropractor | Past | Accepting new patients |
| Cornerstone Chiropractic | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2009025726 | MO | |
| Chiropractor | 111N00000X | 5455 | KY | Yes |
Addresses
Primary practice location
2725 James Sanders Blvd.
Suite a
Poducah, KY 42001-8401
Mailing address
2725 James Sanders Blvd.
Suite a
Poducah, KY 42001-8401
Phone (270) 554-5114
Other providers in Poducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.