Individual provider Active NPI

Penny Harris, DC

  • Chiropractor
  • Georgetown, KY
National Provider Identifier
1700327210
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
276710 Issued in KY
Practice address
108 Osbourne Way Ste 6
Georgetown, KY 40324-9693
Phone
(502) 867-0073
Fax
(502) 867-0560
NPI assigned
Mar 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1362 HI
Chiropractor 111N00000X 276710 KY Primary

Addresses

Primary practice location

108 Osbourne Way Ste 6
Georgetown, KY 40324-9693

Mailing address

108 Osbourne Way Ste 6
Georgetown, KY 40324-9693
Phone (502) 867-0073

Other practice location 1

30 E Lipoa St
Kihei, HI 96753-5821
Phone (808) 270-2530

Other identifiers 1

IdentifierTypeStateIssuer
7100813740MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Georgetown Integrated Medicine PSC CurrentSince Apr 20, 2022 Accepting new patients
On the Go Chiro Chiropractor Current Accepting new patients

Locations

108 Osborne Way
Ste 6
Georgetown, KY 40324
Phone (502) 316-6533

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1700327210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 OSBOURNE WAY STE 6",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249693",
            "telephone_number": "502-867-0073",
            "fax_number": "502-867-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OSBOURNE WAY STE 6",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249693",
            "telephone_number": "502-867-0073",
            "fax_number": "502-867-0560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 E Lipoa St",
            "address_purpose": "LOCATION",
            "city": "Kihei",
            "state": "HI",
            "postal_code": "967535821",
            "country_code": "US",
            "telephone_number": "808-270-2530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "PENNY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "1362",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "276710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100813740",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.