Individual provider Active NPI

Todd Darrow Wolter, D.C.

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1508801168
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4631 Issued in KY
Practice address
1850A S Hurstbourne Pkwy
Louisville, KY 40220-1644
Phone
(502) 493-2400
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4631 KY Primary

Addresses

Primary practice location

1850A S Hurstbourne Pkwy
Louisville, KY 40220-1644

Mailing address

1850A S Hurstbourne Pkwy
Louisville, KY 40220-1644
Phone (502) 493-2400

Other identifiers 1

IdentifierTypeStateIssuer
2445651000MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040512001358 KY Practitioner - Chiropractic 2961492012 Practice locations: Louisville, KY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2304 Hurstbourne Village Dr
Suite 100
Louisville, KY 40299-1856
Phone (502) 493-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4631KYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508801168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850A S HURSTBOURNE PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201644",
            "telephone_number": "502-493-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850A S HURSTBOURNE PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201644",
            "telephone_number": "502-493-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTER",
        "first_name": "TODD",
        "middle_name": "DARROW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2445651000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; 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.