Individual provider Active NPI

Paul J Constante, DC

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1801906698
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4390 Issued in KY
Practice address
3747 Diann Marie Rd
Louisville, KY 40241
Phone
(502) 426-9200
Fax
(502) 426-9259
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4390 KY Primary

Addresses

Primary practice location

3747 Diann Marie Rd
Louisville, KY 40241

Mailing address

3747 Diann Marie Rd
Louisville, KY 40241-3817
Phone (502) 426-9200

Other identifiers 1

IdentifierTypeStateIssuer
85002616MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031205000050 KY Practitioner - Chiropractic 0042115743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Chiropractic PLLCGroup PAC ID 9830572072, 2 clinicians

Practice addresses (Care Compare)

3747 Diann Marie Rd
Louisville, KY 40241-3817
Phone (502) 426-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4390KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Chiropractic PLLC Chiropractor CurrentSince Aug 15, 2022 Accepting new patients

Locations

3747 Diann Marie Rd
Louisville, KY 40241
Phone (502) 426-9200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1801906698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3747 DIANN MARIE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402413817",
            "telephone_number": "502-426-9200",
            "fax_number": "502-426-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 DIANN MARIE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-426-9200",
            "fax_number": "502-426-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTE",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002616",
            "state": "KY"
        }
    ],
    "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 Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.