Individual provider Active NPI

Bambi Dobry Etherton

  • Chiropractor
  • Murray, KY
National Provider Identifier
1821159757
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4821 Issued in KY
Practice address
1103 Chestnut St
Murray, KY 42071-1962
Phone
(270) 759-0030
Fax
(270) 767-0471
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4821 KY Primary

Addresses

Primary practice location

1103 Chestnut St
Murray, KY 42071-1962

Mailing address

1103 Chestnut St
Murray, KY 42071-1962
Phone (270) 759-0030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040203000476 KY Practitioner - Chiropractic 8022901248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etherton Chiropractic of MurrayGroup PAC ID 9032002241, 2 clinicians

Practice addresses (Care Compare)

1103 Chestnut St
Murray, KY 42071-1962
Phone (270) 759-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Etherton Chiropractic of Murray, PSC Chiropractor CurrentSince Sep 8, 2003 Accepting new patients

Locations

1103 Chestnut St
Murray, KY 42071
Phone (270) 759-0030

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1821159757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 CHESTNUT ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420711962",
            "telephone_number": "270-759-0030",
            "fax_number": "270-767-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 CHESTNUT ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420711962",
            "telephone_number": "270-759-0030",
            "fax_number": "270-767-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRY ETHERTON",
        "first_name": "BAMBI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.