Organization Active NPI

Bowling Green Family Chiropractic PLLC

Doing business as Bowling Green Family Chiropractic

  • Chiropractor
  • Bowling Green, KY
National Provider Identifier
1962917682
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BOWLING GREEN FAMILY CHIROPRACTIC PLLC
Doing business as
Bowling Green Family Chiropractic
Practice address
651 US 31W Byp Ste 202
Bowling Green, KY 42101-4977
Phone
(270) 904-1837
Fax
(270) 904-6394
NPI assigned
Dec 4, 2017
Last updated
Oct 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Tosha McCormack
Title
Compliance Officer
Phone
(859) 408-5440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

651 US 31W Byp Ste 202
Bowling Green, KY 42101-4977

Mailing address

651 US 31W Byp Ste 202
Bowling Green, KY 42101-4977
Phone (270) 904-1837

Other identifiers 1

IdentifierTypeStateIssuer
7100583510MedicaidKY

Other names 1

  • Bowling Green Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190212000293 KY Part B Supplier - Clinic/Group Practice 4981942240 Receives reassigned benefits from 2 practitioners
Practice locations: Bowling Green, KY

National Provider Directory

National Provider Directory

Locations

651 US 31W Byp
Ste 202
Bowling Green, KY 42101
Phone (270) 904-1837

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1962917682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 US 31W BYP STE 202",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014977",
            "telephone_number": "270-904-1837",
            "fax_number": "270-904-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 US 31W BYP STE 202",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014977",
            "telephone_number": "270-904-1837",
            "fax_number": "270-904-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWLING GREEN FAMILY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "TOSHA",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "859-408-5440"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100583510",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bowling Green Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.