Active NPI
Kacey Brooke Charles
- Chiropractor
- Mount Carmel, TN
National Provider Identifier
1831673961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3080
- Practice address
- 536 Main St W
Mt Carmel, TN 37645-3564 - Phone
- (423) 256-3232
- NPI assigned
- Sep 25, 2018
- Last updated
- Sep 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3080 | TN | Primary |
Addresses
Primary practice location
536 Main St W
Mt Carmel, TN 37645-3564
Mailing address
536 Main St W
Mt Carmel, TN 37645-3564
Phone (423) 256-3232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190530002700 | TN | Practitioner - Chiropractic | 0446583744 | Practice locations: Mt. Carmel, TN |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
536 Main St W
Mt Carmel, TN 37645-3564
Phone (423) 256-3232
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3080 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537833600000",
"number": "1831673961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "536 MAIN ST W",
"city": "MT CARMEL",
"state": "TN",
"postal_code": "376453564",
"telephone_number": "423-256-3232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "536 MAIN ST W",
"city": "MT CARMEL",
"state": "TN",
"postal_code": "376453564",
"telephone_number": "423-256-3232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "KACEY",
"middle_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-25",
"last_updated": "2018-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TN",
"license": "3080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Carmel, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.