Organization Active NPI

Putty Chiropractic LLC

  • Chiropractor
  • Hopkinsville, KY
National Provider Identifier
1467959742
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4610 Issued in KY
Legal business name
PUTTY CHIROPRACTIC LLC
Practice address
260 Burley Ave
Hopkinsville, KY 42240-8725
Phone
(270) 886-0068
Fax
(270) 890-6068
NPI assigned
Apr 12, 2018
Last updated
Apr 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Authorized official

Name
Mrs. Diane Putty
Title
Manager
Phone
(270) 886-0068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4610 KY Primary

Addresses

Primary practice location

260 Burley Ave
Hopkinsville, KY 42240-8725

Mailing address

260 Burley Ave
Hopkinsville, KY 42240-8725
Phone (270) 886-0068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180424000203 KY Part B Supplier - Clinic/Group Practice 9739442856 Receives reassigned benefits from 1 practitioner
Practice locations: Hopkinsville, KY

National Provider Directory

National Provider Directory

Locations

260 Burley Ave
Hopkinsville, KY 42240
Phone (270) 886-0068

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": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1467959742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 BURLEY AVE",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408725",
            "telephone_number": "270-886-0068",
            "fax_number": "270-890-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 BURLEY AVE",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408725",
            "telephone_number": "270-886-0068",
            "fax_number": "270-890-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTTY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "PUTTY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "270-886-0068",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.