Dawson Spine & Sport Chiropractic, Inc

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

DAWSON SPINE & SPORT CHIROPRACTIC, INC

Practice address

410 W Jefferson St
La Grange, KY 40031-1114

Phone

(502) 465-0055

Fax

(502) 265-1215

NPI assigned

Aug 14, 2020

Last updated

Oct 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brent M Dawson, DONPI 1780032342

Title

Owner/DO

Phone

(502) 465-0055

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

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.

• Brent Michael Dawson, DC

  • Chiropractor
  • Campbellsburg, KY
  • NPI 1780032342
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602547200000",
    "number": "1699386433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W JEFFERSON ST",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400311114",
            "telephone_number": "502-465-0055",
            "fax_number": "502-265-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W JEFFERSON ST",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400311114",
            "telephone_number": "502-465-0055",
            "fax_number": "502-265-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWSON SPINE & SPORT CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-10-13",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/DO",
        "authorized_official_telephone_number": "502-465-0055",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Daniel, M.D.
• Savannah Elise Daugherty, M.A., CCC-SLP
• Sogol Davari
• Kamlesh C Dave, MD
• Laura Davis
• Mackenzie Belle Day
• Lisa Michelle Dean, OTR/L
• Mackenzie Dean
• Tracy Lynn Dean
• David Morris Decuir, RPH

• Sports Physician Chiropractor in La Grange, KY
• Providers in La Grange, KY by specialty
• Sports Physician Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.