Individual provider Active NPI

Steven Hannegan, D.C.

  • Chiropractor
  • Wilder, KY
National Provider Identifier
1497040851
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5277 Issued in KY
Practice address
419 Licking Pike Ste B
Wilder, KY 41071-3046
Phone
(859) 360-0664
Fax
(859) 360-3143
NPI assigned
Jun 14, 2011
Last updated
Jan 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5277 KY Primary

Addresses

Primary practice location

419 Licking Pike Ste B
Wilder, KY 41071-3046

Mailing address

419 Licking Pike Ste B
Wilder, KY 41071-3046
Phone (859) 360-0664

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111027000889 KY Practitioner - Chiropractic 6507039088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

419 Licking Pike
Suite B
Wilder, KY 41071-3046
Phone (859) 360-0664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Health & Rehabilitation Chiropractic Center PLLC CurrentSince Jul 13, 2011 Accepting new patients

Locations

419 Licking Pike
Ste B
Wilder, KY 41071
Phone (859) 360-0664

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1497040851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 LICKING PIKE STE B",
            "city": "WILDER",
            "state": "KY",
            "postal_code": "410713046",
            "telephone_number": "859-360-0664",
            "fax_number": "859-360-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 LICKING PIKE STE B",
            "city": "WILDER",
            "state": "KY",
            "postal_code": "410713046",
            "telephone_number": "859-360-0664",
            "fax_number": "859-360-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNEGAN",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilder, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.