Active NPI
Felty Blake Colwell, DC
- Chiropractor
- Radcliff, KY
National Provider Identifier
1942283643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3955
- Practice address
- 815 W Lincoln Trail Blvd
Radcliff, KY 40160-2670 - Phone
- (270) 351-3736
- Fax
- (270) 351-3739
- NPI assigned
- Nov 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 | 3955 | KY | Primary |
Addresses
Primary practice location
815 W Lincoln Trail Blvd
Radcliff, KY 40160-2670
Mailing address
815 W Lincoln Trail Blvd
Radcliff, KY 40160-2670
Phone (270) 351-3736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61-1158922 | Other | KY | FEDERAL TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120524000443 | KY | Practitioner - Chiropractic | 7810150125 | Practice locations: Radcliff, KY |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
815 A W Lincoln Trail Blvd
PO Box 1198
Radcliff, KY 40160-2670
815 W Lincoln Trail Blvd
Suite a
Radcliff, KY 40160-2670
815 W Lincoln Trail Blvd a
Radcliff, KY 40160-2670
Phone (270) 351-3736
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1942283643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 W LINCOLN TRAIL BLVD",
"city": "RADCLIFF",
"state": "KY",
"postal_code": "401602670",
"telephone_number": "270-351-3736",
"fax_number": "270-351-3739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 W LINCOLN TRAIL BLVD",
"city": "RADCLIFF",
"state": "KY",
"postal_code": "401602670",
"telephone_number": "270-351-3736",
"fax_number": "270-351-3739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLWELL",
"first_name": "FELTY",
"middle_name": "BLAKE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-28",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "3955",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "61-1158922",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Radcliff, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.