Kevin Ellis, DC
Individual provider Active NPI Chiropractor · Franklin, KY
NPI 1336987635 · NPPES record last updated Jul 19, 2024
Key facts
- NPI
- 1336987635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 293670 (KY)
- Practice address
- 208 S Main St Ste 120
Franklin, KY 42134-2116 - Phone
- (270) 806-0023
- NPI assigned
- Jul 19, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240910000696 | KY | Practitioner - Chiropractic | 8123568763 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 293670 | KY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spine Stop Franklin, PLLC | Chiropractor | Current |
Accepting new patients |
Locations
208 S Main St
Ste 120
Franklin, KY 42134
Phone (270) 806-0023
208 S Main St
Franklin, KY 42134
Phone (270) 781-6477
352 Old Gallatin Rd
Scottsville, KY 42164
Phone (270) 239-2225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 293670 | KY | Yes |
Addresses
Primary practice location
208 S Main St Ste 120
Franklin, KY 42134-2116
Mailing address
352 Old Gallatin Rd
Scottsville, KY 42164-8666
Phone (270) 237-3304
Other providers in Franklin, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.