Lisa A Tack, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4311 Issued in KY

Practice address

5131 US Highway 62
Calvert City, KY 42029-8390

Phone

(270) 395-4540

Fax

(270) 395-7715

NPI assigned

Aug 9, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bradley a Tack PSCGroup PAC ID 7113952409, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bradley a. Tack P.S.C.

  dba Calvert City Chiropractic

  • Chiropractor
  • Calvert City, KY
  • NPI 1003969460
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619978129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 OAK SHADOW LN",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420255494",
            "telephone_number": "270-527-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 US HIGHWAY 62",
            "city": "CALVERT CITY",
            "state": "KY",
            "postal_code": "420298390",
            "telephone_number": "270-395-4540",
            "fax_number": "270-395-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACK",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85001477",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Christine Stariwat, COTA/L
• Scott C Stephenson
• Jenny Sanderson Story, MSCCCSLP
• Rita Tabor
• Bradley A Tack, D.C.
• Amanda Michelle Travis, PTA
• Barry Jay Wilson, D.M.D.
• Courtney Wilson, PHARM.D

• Chiropractor in Calvert City, KY
• Providers in Calvert City, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.