Individual provider Active NPI

Rodrick C. Hahn, D.C.

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1922021575
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4365 Issued in KY
Practice address
1679 Old Preston Hwy N
Suite 6
Louisville, KY 40229-3297
Phone
(502) 957-1021
Fax
(502) 957-1703
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4365 KY Primary

Addresses

Primary practice location

1679 Old Preston Hwy N
Suite 6
Louisville, KY 40229-3297

Mailing address

1679 Old Preston Hwy N
Suite 6
Louisville, KY 40229-3297
Phone (502) 957-1021

Other identifiers 9

IdentifierTypeStateIssuer
244548000-2445427000OtherKYPASSPORT ADVANTAGE
000000041631OtherKYANTHEM
5674124OtherKYCIGNA
85002988MedicaidKY
P00154881OtherKYRAILROAD MEDICARE PIN
44-00228OtherKYUNITED HEALTHCARE
2426754OtherKYAETNA
DC2130OtherKYRAILROAD MEDICARE GROUP #
50004038-50004037OtherKYPASSPORT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308000557 KY Practitioner - Chiropractic 4284522632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1679 Old Preston Hwy N
Suite 6
Louisville, KY 40229-3297
Phone (502) 957-1021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4365KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crackerback, Inc Chiropractor CurrentSince Sep 1, 2000 Accepting new patients

Locations

1679 Old Preston Hwy N
Ste 6
Louisville, KY 40229
Phone (502) 957-1021

1679 Old Preston Hwy N
Louisville, KY 40229

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1922021575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1679 OLD PRESTON HWY N",
            "address_2": "SUITE 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402293297",
            "telephone_number": "502-957-1021",
            "fax_number": "502-957-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 OLD PRESTON HWY N",
            "address_2": "SUITE 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402293297",
            "telephone_number": "502-957-1021",
            "fax_number": "502-957-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHN",
        "first_name": "RODRICK",
        "middle_name": "C.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "244548000-2445427000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000041631",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5674124",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002988",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00154881",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "44-00228",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2426754",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "DC2130",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50004038-50004037",
            "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 Mar 3, 2008; 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.