Crackerback, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4365 Issued in KY

Legal business name

CRACKERBACK, INC

Practice address

1679 Old Preston Hwy N
Suite 6
Louisville, KY 40229-3297

Phone

(502) 957-1021

Fax

(502) 957-1703

NPI assigned

Mar 4, 2008

Organization subpart

No

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

Authorized official

Name

Rodrick C Hahn, D.C.NPI 1922021575

Title

President

Phone

(502) 957-1021

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Family Care Chiropractic, Hillview Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rodrick C. Hahn, D.C.

  • Chiropractor
  • Louisville, KY
  • NPI 1922021575
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1548430747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1679 OLD PRESTON HWY N",
            "address_2": "SUITE 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402293297",
            "telephone_number": "502-957-1021",
            "fax_number": "502-957-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 OLD PRESTON HWY N",
            "address_2": "SUITE 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402293297",
            "telephone_number": "502-957-1021",
            "fax_number": "502-957-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRACKERBACK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "RODRICK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-957-1021",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "8907",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DC2130",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Care Chiropractic, Hillview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia Sue Crabtree, D.O.
• Garrett M Crabtree, M.D.
• Katherine Elaine Crabtree
• Taryn Crabtree
• William Crabtree
• Briana Craddock
• Briana Michelle Craddock, APRN
• Durrett Craddock, MD
• Megan Craddock
• Cradle Resilience Behavioral Health

• Chiropractor in Louisville, KY
• Providers in Louisville, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.