Revive Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REVIVE CHIROPRACTIC LLC

Practice address

38 Ridgewood Professional CT
Madisonville, KY 42431-9486

Phone

(270) 821-9020

Fax

(270) 821-9750

NPI assigned

Jan 6, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Cheri Carlisle

Title

Billing/Credentialing Manager

Phone

(270) 821-9020

Specialties & licenses 1

Addresses

Other names 1

• Revive Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 4

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

• Neal Alan Johnson, DC

  • Chiropractor
  • Madisonville, KY
  • NPI 1740117217
  Medicare reassignment NPD
• Marina Kay McCay, D.C.

  • Chiropractor
  • Madisonville, KY
  • NPI 1649496654
  Medicare reassignment NPD
• Alexandria Cole Stone, DC

  • Chiropractor
  • Madisonville, KY
  • NPI 1053166884
  Medicare reassignment NPD
• Blake E Taylor, DC

  • Chiropractor
  • Madisonville, KY
  • NPI 1285348078
  Medicare reassignment NPD

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1336853134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 RIDGEWOOD PROFESSIONAL CT",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319486",
            "telephone_number": "270-821-9020",
            "fax_number": "270-821-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 RIDGEWOOD PROFESSIONAL CT",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319486",
            "telephone_number": "270-821-9020",
            "fax_number": "270-821-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "CHERI",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "270-821-9020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regional Health Care Affiliates Inc
• Susan Reid
• Kavya Mounika Remala, MD
• Theresia Renner, PA-C
• Whitney Jo Ressett, PT, DPT, OCS
• Torie Reynolds
• Stuart Wayne Rice, M.D.
• Jerry Rickard
• Kassy Rickard, APRN, FNP-BC
• Vendonna Rickard

• Chiropractor in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.