Bluegrass Family Chiropractic PLLC
Organization Active NPI Chiropractor · Prestonsburg, KY
NPI 1780118877 · NPPES record last updated Nov 14, 2022
Key facts
- NPI
- 1780118877
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5463 (KY)
- Legal business name
- BLUEGRASS FAMILY CHIROPRACTIC PLLC
- Practice address
- Bluegrass Family Chiropractic PLLC
30 S Lake Dr
Prestonsburg, KY 41653 - Phone
- (606) 886-1416
- Fax
- (606) 886-8849
- NPI assigned
- Apr 14, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Leyton P Childers, D.C.
- Title
- Owner
- Phone
- (606) 886-1416
Practitioners 5
-
Leyton Childers, DC
-
Emily Parsons, DC
-
Philip Richard Simpson, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170420000959 | KY | Part B Supplier - Clinic/Group Practice | 1254617566 |
Receives reassigned benefits from 2 practitioners Practice locations: Prestonsburg, KY |
National Provider Directory
Locations
1191 S Lake Dr
Prestonsburg, KY 41653
Phone (606) 791-7435
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 5463 | KY | Yes |
Addresses
Primary practice location
Bluegrass Family Chiropractic PLLC
30 S Lake Dr
Prestonsburg, KY 41653
Mailing address
530 S Lake Drive
Prestonsburg, KY 41653
Phone (606) 886-1416
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100389560 | Medicaid | KY |
Other providers in Prestonsburg, KY
- Christal A Blevins
- Hannah Marie Blevins
- Melissa Blevins
- David J Bliss
- Bluegrass Family Agency Inc
- Bluegrass Nutrition Solutions
- Bluegrass Therapy PLLC
- Jason Scott Bluemlein
- Imani Blunt
- Clinton Boarman
All providers in Prestonsburg, KY · Chiropractor in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.