Individual provider Active NPI

Wade Allen Davis, D.C.

  • Chiropractor
  • Somerset, KY
National Provider Identifier
1619272598
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5276 Issued in KY
Practice address
604 Ogden St
Ste 202
Somerset, KY 42501-1795
Phone
(606) 679-1991
Fax
(606) 679-1149
NPI assigned
Jan 24, 2011
Last updated
Jan 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5276 KY Primary

Addresses

Primary practice location

604 Ogden St
Ste 202
Somerset, KY 42501-1795

Mailing address

650 S Highway 27
Ste 5-315
Somerset, KY 42501-3501
Phone (606) 679-1991

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110321000866 KY Practitioner - Chiropractic 2668655150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

140 W Main St
Mount Vernon, KY 40456-2972
Phone (606) 392-2110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5276KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Chiropractic LLC Chiropractor CurrentSince May 6, 2019 Accepting new patients

Locations

100 Hardin Ln
Ste C
Somerset, KY 42503
Phone (606) 279-5679

604 Ogden St
Ste 202
Somerset, KY 42501
Phone (606) 679-1991

650 S Highway 27
Ste 5315
Somerset, KY 42501
Phone (606) 679-1991

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": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1619272598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S HIGHWAY 27",
            "address_2": "STE 5-315",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425013501",
            "telephone_number": "606-679-1991",
            "fax_number": "606-679-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 OGDEN ST",
            "address_2": "STE 202",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425011795",
            "telephone_number": "606-679-1991",
            "fax_number": "606-679-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WADE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.