Individual provider Active NPI

Travis Wade Kahre, DC

  • Chiropractor
  • Paducah, KY
National Provider Identifier
1700960317
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4857 Issued in KY
Practice address
3333 Irvin Cobb Dr Ste 104
Paducah, KY 42003-0526
Phone
(270) 442-2211
Fax
(270) 933-1054
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4857 KY Primary

Addresses

Primary practice location

3333 Irvin Cobb Dr Ste 104
Paducah, KY 42003-0526

Mailing address

3333 Irvin Cobb Dr Ste 104
Paducah, KY 42003-0526
Phone (270) 442-2211

Other identifiers 1

IdentifierTypeStateIssuer
85003093MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000004 KY Practitioner - Chiropractic 8820060767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3333 Irvin Cobb Dr
Suite 104
Paducah, KY 42003-0526
Phone (270) 442-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4857KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Family Chiropractic Chiropractor CurrentSince Oct 20, 2009 Accepting new patients
McCracken County Chiropractic Chiropractor Past Accepting new patients
McCracken County Chiropractic PSC Chiropractor PastSince Apr 10, 2012 Accepting new patients

Locations

3333 Irvin Cobb Dr
Ste 104
Paducah, KY 42003
Phone (270) 217-4259

Organizations & group practices 3

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1700960317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 IRVIN COBB DR STE 104",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420030526",
            "telephone_number": "270-442-2211",
            "fax_number": "270-933-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 IRVIN COBB DR STE 104",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420030526",
            "telephone_number": "270-442-2211",
            "fax_number": "270-933-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHRE",
        "first_name": "TRAVIS",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85003093",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.