Organization Active NPI

Active Body Chiropractic and Injury Center PLLC

Doing business as Family Chiropractic of Harrodsburg

  • Chiropractor
  • Harrodsburg, KY
National Provider Identifier
1457535973
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ACTIVE BODY CHIROPRACTIC AND INJURY CENTER PLLC
Doing business as
Family Chiropractic of Harrodsburg
Practice address
507 Joseph Dr.
Ste. 4
Harrodsburg, KY 40330
Phone
(859) 734-2800
Fax
(859) 734-2805
NPI assigned
Dec 19, 2007
Last updated
Oct 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Tosha McCormack
Title
Compliance Officer
Phone
(859) 408-5440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

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 names 1

  • Family Chiropractic of Harrodsburg Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050427000073 KY Part B Supplier - Clinic/Group Practice 6103865423 Receives reassigned benefits from 3 practitioners
Practice locations: Harrodsburg, KY

National Provider Directory

National Provider Directory

Locations

507 Joseph Dr
Ste 4
Harrodsburg, KY 40330
Phone (859) 734-2800

Practitioners & affiliated clinicians

Practitioners 5

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": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1457535973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 JOSEPH DR.",
            "address_2": "STE. 4",
            "city": "HARRODSBURG",
            "state": "KY",
            "postal_code": "40330",
            "telephone_number": "859-734-2800",
            "fax_number": "859-734-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 JOSEPH DR.",
            "address_2": "STE. 4",
            "city": "HARRODSBURG",
            "state": "KY",
            "postal_code": "40330",
            "telephone_number": "859-734-2800",
            "fax_number": "859-734-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE BODY CHIROPRACTIC AND INJURY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "TOSHA",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "859-408-5440"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Chiropractic of Harrodsburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Chiropractic of Harrodsburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrodsburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.