Individual provider Active NPI

Kevin Cornelius Carter, DC

  • Chiropractor
  • Hendersonville, TN
National Provider Identifier
1497718365
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1782 Issued in TN
Practice address
136 Walton Ferry Rd Ste 1B
Hendersonville, TN 37075-3928
Phone
(615) 289-5823
Fax
(615) 826-8480
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1782 TN Primary

Addresses

Primary practice location

136 Walton Ferry Rd Ste 1B
Hendersonville, TN 37075-3928

Mailing address

136 Walton Ferry Rd Ste 1B
Hendersonville, TN 37075-3928
Phone (615) 289-5823

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050308000460 TN Practitioner - Chiropractic 2163476623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

136 Walton Ferry Dr
Suite 1B
Hendersonville, TN 37075-3772
Phone (615) 289-5823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1782TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carter Chiropractic Offices LLC Chiropractor CurrentSince Mar 1, 2005 Accepting new patients
Selby Chiropractic Offices,P.C. Chiropractor Past Accepting new patients

Locations

260 W Main St
Ste 101A
Hendersonville, TN 37075

136 Walton Ferry Rd
Ste 1B
Hendersonville, TN 37075
Phone (615) 289-5823

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1497718365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 WALTON FERRY RD STE 1B",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753928",
            "telephone_number": "615-289-5823",
            "fax_number": "615-826-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 WALTON FERRY RD STE 1B",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753928",
            "telephone_number": "615-289-5823",
            "fax_number": "615-826-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KEVIN",
        "middle_name": "CORNELIUS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.