Organization Active NPI

Chad C. Henderson DC, PSC

  • Chiropractor
  • Somerset, KY
National Provider Identifier
1306875554
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHAD C. HENDERSON DC, PSC
Practice address
1056 S Highway 27
Somerset, KY 42501-2893
Phone
(606) 679-6385
Fax
(606) 679-5556
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Authorized official

Name
Dr. Chad C Henderson, DCNPI 1740224542
Title
Doctor of Chiropractic/Owner
Phone
(606) 679-6385

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1056 S Highway 27
Somerset, KY 42501-2893

Mailing address

1056 S Highway 27
Somerset, KY 42501-2893
Phone (606) 679-6385

Other identifiers 1

IdentifierTypeStateIssuer
85900603MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061018000468 KY Part B Supplier - Clinic/Group Practice 5496751240 Receives reassigned benefits from 2 practitioners
Practice locations: Somerset, KY

National Provider Directory

National Provider Directory

Locations

1056 S Highway 27
Somerset, KY 42501
Phone (606) 679-6385

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1306875554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 S HIGHWAY 27",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012893",
            "telephone_number": "606-679-6385",
            "fax_number": "606-679-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 S HIGHWAY 27",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012893",
            "telephone_number": "606-679-6385",
            "fax_number": "606-679-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAD C. HENDERSON DC, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC/OWNER",
        "authorized_official_telephone_number": "606-679-6385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85900603",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.