Organization Active NPI

Spine Stop Bowling Green, PLLC

  • Chiropractor
  • Bowling Green, KY
National Provider Identifier
1811476880
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SPINE STOP BOWLING GREEN, PLLC
Practice address
760 Campbell LN
Bowling Green, KY 42104-1085
Phone
(270) 237-3304
NPI assigned
Aug 10, 2018
Last updated
Aug 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Authorized official

Name
Dr. Grant G Watkins II, DCNPI 1144251448
Title
Member
Phone
(270) 237-3304

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

760 Campbell LN
Bowling Green, KY 42104-1085

Mailing address

352 Old Gallatin Rd
Scottsville, KY 42164-8666
Phone (270) 237-3304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181119001393 KY Part B Supplier - Clinic/Group Practice 6800140419 Receives reassigned benefits from 8 practitioners
Practice locations: Bowling Green, KY

National Provider Directory

National Provider Directory

Locations

760 Campbell Ln
Ste 120
Bowling Green, KY 42104
Phone (270) 781-3937

Practitioners & affiliated clinicians

Practitioners 8

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": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533859200000",
    "number": "1811476880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 OLD GALLATIN RD",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421648666",
            "telephone_number": "270-237-3304",
            "fax_number": "270-237-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 CAMPBELL LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421041085",
            "telephone_number": "270-237-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE STOP BOWLING GREEN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2018-08-10",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "270-237-3304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.