Organization Active NPI

Laurel County Chiropractic

  • Chiropractor
  • London, KY
National Provider Identifier
1396048328
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LAUREL COUNTY CHIROPRACTIC
Practice address
164 London Shopping Ctr
London, KY 40741-3015
Phone
(606) 864-3595
Fax
(606) 878-5499
NPI assigned
Dec 14, 2010
Last updated
Dec 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Authorized official

Name
Dr. Anthony Decarlo, D.C.NPI 1982797585
Title
Chiropractor
Phone
(606) 864-3595

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 Primary

Addresses

Primary practice location

164 London Shopping Ctr
London, KY 40741-3015

Mailing address

164 London Shopping Ctr
London, KY 40741-3015
Phone (606) 864-3595

Other identifiers 1

IdentifierTypeStateIssuer
85036523MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110104000566 KY Part B Supplier - Clinic/Group Practice 9032308242 Receives reassigned benefits from 1 practitioner
Practice locations: London, KY

National Provider Directory

National Provider Directory

Locations

164 London Shopping Ctr
London, KY 40741
Phone (606) 864-3595

Practitioners & affiliated clinicians

Practitioners 1

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": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1396048328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 LONDON SHOPPING CTR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407413015",
            "telephone_number": "606-864-3595",
            "fax_number": "606-878-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 LONDON SHOPPING CTR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407413015",
            "telephone_number": "606-864-3595",
            "fax_number": "606-878-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL COUNTY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "DECARLO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "606-864-3595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85036523",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.