NPIMap

Organization Active NPI

12TH Street Chiropractic & Injury Rehabilitation, PSC

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1710294541
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
12TH STREET CHIROPRACTIC & INJURY REHABILITATION, PSC
Practice address
1211 W Broadway Unit 101
Louisville, KY 40203-2082
Phone
(502) 587-7328
Fax
(502) 587-7355
NPI assigned
Aug 31, 2010
Last updated
Sep 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Authorized official

Name
Michael Clover
Title
Chiropractor
Phone
(502) 386-1594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

1211 W Broadway Unit 101
Louisville, KY 40203-2082

Mailing address

1211 W Broadway Unit 101
Louisville, KY 40203-2082
Phone (502) 587-7328

National Provider Directory

National Provider Directory

Locations

1211 W Broadway
Unit 101
Louisville, KY 40203
Phone (502) 587-7328

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1710294541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W BROADWAY UNIT 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032082",
            "telephone_number": "502-587-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W BROADWAY UNIT 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032082",
            "telephone_number": "502-587-7328",
            "fax_number": "502-587-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "12TH STREET CHIROPRACTIC & INJURY REHABILITATION, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "CLOVER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "502-386-1594"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.