NPIMap

Organization Active NPI

Lebanon Chiropractic, PLLC

  • Chiropractor
  • Lebanon, KY
National Provider Identifier
1639616253
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4427 Issued in KY
Legal business name
LEBANON CHIROPRACTIC, PLLC
Practice address
496 W Main St
Lebanon, KY 40033-1362
Phone
(270) 692-6555
Fax
(270) 692-5751
NPI assigned
Jan 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Dr. Jeffrey Roberts, D.C.
Title
Sole Member
Phone
(270) 692-6555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4427 KY Primary

Addresses

Primary practice location

496 W Main St
Lebanon, KY 40033-1362

Mailing address

496 W Main St
Lebanon, KY 40033-1362
Phone (270) 692-6555

Other identifiers 1

IdentifierTypeStateIssuer
000000051836OtherKYANTHEM

Other names 1

  • Jeffrey A. Roberts, D.C. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1639616253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 W MAIN ST",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331362",
            "telephone_number": "270-692-6555",
            "fax_number": "270-692-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 W MAIN ST",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331362",
            "telephone_number": "270-692-6555",
            "fax_number": "270-692-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "270-692-6555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000051836",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey A. Roberts, D.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lebanon, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.