West Kentucky Chiropractic and Performance Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WEST KENTUCKY CHIROPRACTIC AND PERFORMANCE CENTER

Doing business as

West Kentucky Chiropractic and Performance

Practice address

110B E 5TH St
Benton, KY 42025-1118

Phone

(270) 703-7074

NPI assigned

Jan 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Tanner Evans, DCNPI 1942849179

Title

Owner/Operator/Chiropractor

Phone

(270) 703-7074

Specialties & licenses 1

Addresses

Other names 1

• West Kentucky Chiropractic and Performance Doing business as

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.

• Tanner Evans, DC

  • Chiropractor
  • Benton, KY
  • NPI 1942849179
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1700416450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LONGACRE LN",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110B E 5TH ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251118",
            "telephone_number": "270-703-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST KENTUCKY CHIROPRACTIC AND PERFORMANCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TANNER",
        "authorized_official_title_or_position": "OWNER/OPERATOR/CHIROPRACTOR",
        "authorized_official_telephone_number": "270-703-7074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Kentucky Chiropractic and Performance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Kentucky Chiropractic and Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Garrison Scott Wagner, PHARMD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0143)
• Wal-Mart Stores East, LP (Vision Center 30-0143)
• Charles Waller, MD
• Wendy Sowell Gibson OD
• Saundra H White, APRN
• Madison Brooke Wilkins, RBT
• James Blake Wiseman, PHARMD.
• Kandice Joette Wommack, D.C.

• Chiropractor in Benton, KY
• Providers in Benton, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.