Individual provider Active NPI

Larry J Pacey, DC

  • Chiropractor
  • Wellington, KS
National Provider Identifier
1720170699
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-03212 Issued in KS
Practice address
306 W 8TH St
Wellington, KS 67152-3923
Phone
(620) 326-3611
Fax
(620) 326-6939
NPI assigned
Sep 29, 2006
Last updated
Nov 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-03212 KS Primary

Addresses

Primary practice location

306 W 8TH St
Wellington, KS 67152-3923

Mailing address

306 W 8TH St
Wellington, KS 67152-3923
Phone (620) 326-3611

Other identifiers 1

IdentifierTypeStateIssuer
005486OtherKSBLUE CROSS BLUE SHIELD

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
01-03212KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Goodrum Health Enterprises PA Chiropractor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1720170699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W 8TH ST",
            "city": "WELLINGTON",
            "state": "KS",
            "postal_code": "671523923",
            "telephone_number": "620-326-3611",
            "fax_number": "620-326-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W 8TH ST",
            "city": "WELLINGTON",
            "state": "KS",
            "postal_code": "671523923",
            "telephone_number": "620-326-3611",
            "fax_number": "620-326-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACEY",
        "first_name": "LARRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-03212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "005486",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.