Organization Active NPI

Lynn-Gail PLLC

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1457554503
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4867 Issued in KY
Legal business name
LYNN-GAIL PLLC
Practice address
4123 Taylor Blvd
Louisville, KY 40215-2341
Phone
(502) 363-7172
Fax
(502) 363-7174
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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

Authorized official

Name
Dawn Wietfeldt, DC
Title
President
Phone
(502) 647-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4867 KY Primary

Addresses

Primary practice location

4123 Taylor Blvd
Louisville, KY 40215-2341

Mailing address

60 Stonecrest CT
Suite 140
Shelbyville, KY 40065-8155
Phone (502) 647-4600

Other identifiers 1

IdentifierTypeStateIssuer
4867OtherKYSTATE LICENSE NUMBER

Other names 1

  • Shivley Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

4300 Outer Loop
Ste 10
Louisville, KY 40219
Phone (502) 363-7172

60 Stonecrest Ct
Ste 140
Shelbyville, KY 40065
Phone (502) 647-4600

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1457554503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 STONECREST CT",
            "address_2": "SUITE 140",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658155",
            "telephone_number": "502-647-4600",
            "fax_number": "502-647-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 TAYLOR BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402152341",
            "telephone_number": "502-363-7172",
            "fax_number": "502-363-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN-GAIL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "WIETFELDT",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-647-4600",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "4867",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shivley Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.