Travis Stout Thaler, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5376 Issued in KY

Practice address

138B S Green St
Henderson, KY 42420

Phone

(270) 830-0070

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• On the River Chiropractic PSC

  dba Healthsource Chiropractic

  • Chiropractor
  • Henderson, KY
  • NPI 1467880963
  Medicare reassignment NPD Authorized official
• Thaler Chiropractic

  • Chiropractor
  • Moncks Corner, SC
  • NPI 1457444689
  NPD (past) Authorized official

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1770685349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138B S GREEN ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424203539",
            "telephone_number": "270-830-0070",
            "fax_number": "270-830-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138B S GREEN ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "42420",
            "telephone_number": "270-830-0070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Gulledge St",
            "address_purpose": "LOCATION",
            "city": "Moncks Corner",
            "state": "SC",
            "postal_code": "294613747",
            "country_code": "US",
            "telephone_number": "843-761-0070",
            "fax_number": "843-761-0072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THALER",
        "first_name": "TRAVIS",
        "middle_name": "STOUT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100279150",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Tapp, LICENSED PEDORTHIST
• Kiersten J Taylor
• Betty Teer
• Michael Jerry Tenery, D.M.D.
• Eula Geralyn Plana Tetangco, M.D.
• The Children's Advocacy Center of Green River District
• The Heart Group
• Therapy Associates, Inc.
• Bonnie Lynn Thomas, LPCC
• Carli Thomas

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.