Organization Active NPI

Chiropractic Louisville PLLC

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1770796476
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROPRACTIC LOUISVILLE PLLC
Practice address
152 Thierman LN
Louisville, KY 40207-5010
Phone
(502) 891-0333
Fax
(502) 721-0086
NPI assigned
May 8, 2007
Reactivated
Sep 11, 2007
Last updated
Apr 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
Gregory Shane Thomas, DCNPI 1851310460
Title
Chiropractor
Phone
(502) 891-0333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

152 Thierman LN
Louisville, KY 40207-5010

Mailing address

152 Thierman LN
Louisville, KY 40207-5010
Phone (502) 891-0333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160114002399 KY Part B Supplier - Clinic/Group Practice 1850694407 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

152 Thierman Ln
Louisville, KY 40207
Phone (502) 891-0333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1770796476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 THIERMAN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075010",
            "telephone_number": "502-891-0333",
            "fax_number": "502-721-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 THIERMAN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075010",
            "telephone_number": "502-891-0333",
            "fax_number": "502-721-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC LOUISVILLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2008-04-03",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "502-891-0333",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "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 Apr 3, 2008; 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.