Active Body Chiropractic and Injury Center PLLC
Organization Active NPI Chiropractor · Harrodsburg, KY
NPI 1457535973 · NPPES record last updated Oct 6, 2022
Key facts
- NPI
- 1457535973
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- ACTIVE BODY CHIROPRACTIC AND INJURY CENTER PLLC
- Practice address
- 507 Joseph Dr.
Ste. 4
Harrodsburg, KY 40330 - Phone
- (859) 734-2800
- Fax
- (859) 734-2805
- NPI assigned
- Dec 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Tosha McCormack
- Title
- Compliance Officer
- Phone
- (859) 408-5440
Practitioners 5
-
Truemon Barger, D.C.
-
Stephanie Leon, DC
-
Callie Short, D.C.
-
Simon Peter Bitz, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050427000073 | KY | Part B Supplier - Clinic/Group Practice | 6103865423 |
Receives reassigned benefits from 3 practitioners Practice locations: Harrodsburg, KY |
National Provider Directory
Locations
507 Joseph Dr
Ste 4
Harrodsburg, KY 40330
Phone (859) 734-2800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
507 Joseph Dr.
Ste. 4
Harrodsburg, KY 40330
Mailing address
507 Joseph Dr.
Ste. 4
Harrodsburg, KY 40330
Phone (859) 734-2800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100293130 | Medicaid | KY | |
| 00759001 | Other | KY | MEDICARE PTIN |
Other names
- Family Chiropractic of Harrodsburg
Other providers in Harrodsburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2022. 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.