Organization Active NPI

Chiro One Wellness Center of Georgetown PLLC

  • Chiropractor
  • Georgetown, KY
National Provider Identifier
1578882536
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIRO ONE WELLNESS CENTER OF GEORGETOWN PLLC
Practice address
108 Osbourne Way
Suite 6
Georgetown, KY 40324-9693
Phone
(606) 831-4432
Fax
(502) 867-0560
NPI assigned
May 28, 2010
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Dr. Jeremiah Holmes, DCNPI 1689771081
Title
Owner
Phone
(606) 831-4432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

108 Osbourne Way
Suite 6
Georgetown, KY 40324-9693

Mailing address

3738 Solutions Ctr
#773738
Chicago, IL 60677-0001
Phone (606) 831-4432

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100702000358 KY Part B Supplier - Clinic/Group Practice 1052442258 Receives reassigned benefits from 4 practitioners
Practice locations: Georgetown, KY

National Provider Directory

National Provider Directory

Locations

3738 Solutions Ctr
#773738
Chicago, IL 60677

108 Osborne Way
Ste 6
Georgetown, KY 40324
Phone (502) 316-6533

Practitioners & affiliated clinicians

Practitioners 7

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": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1578882536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3738 SOLUTIONS CTR",
            "address_2": "#773738",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770001",
            "telephone_number": "606-831-4432",
            "fax_number": "859-264-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OSBOURNE WAY",
            "address_2": "SUITE 6",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249693",
            "telephone_number": "606-831-4432",
            "fax_number": "502-867-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF GEORGETOWN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-831-4432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.