Jason W Runyon, D.C.
Individual provider Active NPI Chiropractor · Flatwoods, KY
NPI 1679617344 · NPPES record last updated Jul 23, 2015
Key facts
- NPI
- 1679617344
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4816 (KY)
- Practice address
- 2412 Argillite Rd
Flatwoods, KY 41139-1996 - Phone
- (606) 833-9355
- Fax
- (606) 833-1895
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2412 Argillite Rd
Flatwoods, KY 41139-1996
Phone (606) 833-9355
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040916000674 | KY | Practitioner - Chiropractic | 1052388402 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4816 | KY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Runyon Specific Chiropractic, LLC | Chiropractor | Current |
Accepting new patients |
Locations
1448 Diederich Blvd
Russell, KY 41169
Phone (606) 834-0020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4816 | KY | Yes |
Addresses
Primary practice location
2412 Argillite Rd
Flatwoods, KY 41139-1996
Mailing address
PO Box 741
Ashland, KY 41105-0741
Phone (606) 833-9355
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2634242 | Medicaid | OH | |
| 85003416 | Medicaid | KY | |
| 000000336562 | Other | KY | BLUE CROSS BLUE SHIELD |
Other providers in Flatwoods, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.