Organization Active NPI

Beacon of Light Family Chiropractic, PLLC

  • Chiropractor
  • Middlesboro, KY
National Provider Identifier
1851716369
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4914 Issued in KY
Legal business name
BEACON OF LIGHT FAMILY CHIROPRACTIC, PLLC
Practice address
311 N 12TH St
Middlesboro, KY 40965-1135
Phone
(606) 302-4011
Fax
(606) 302-4085
NPI assigned
Feb 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Dr. Jason Stuart TaylorNPI 1679629620
Title
Owner/Chiropractor
Phone
(606) 302-4011

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 4914 KY Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 4890 KY

Addresses

Primary practice location

311 N 12TH St
Middlesboro, KY 40965-1135

Mailing address

311 N 12TH St
Middlesboro, KY 40965-1135
Phone (606) 302-4011

Other identifiers 4

IdentifierTypeStateIssuer
1245046457OtherKYNPI
7100183000MedicaidKY
7100187940MedicaidKY
1538686134OtherKYNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160627001054 KY Part B Supplier - Clinic/Group Practice 2264723063 Receives reassigned benefits from 3 practitioners
Practice locations: Middlesboro, KY

National Provider Directory

National Provider Directory

Locations

311 N 12th St
Middlesboro, KY 40965
Phone (606) 302-4011

1313 Cumberland Ave
Middlesboro, KY 40965
Phone (606) 248-1388

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1851716369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N 12TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651135",
            "telephone_number": "606-302-4011",
            "fax_number": "606-302-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N 12TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651135",
            "telephone_number": "606-302-4011",
            "fax_number": "606-302-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON OF LIGHT FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "606-302-4011",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4914",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4890",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1245046457",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100183000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100187940",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1538686134",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.