DR. LISA A TACK (NPI# 1619978129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619978129 |
| Entity Type | Individual |
| Full Name | DR. LISA A TACK |
| Credential | D.C. |
| Practice Address |
5131 Us Highway 62 Calvert City KY 42029-8390 |
| Mailing Address |
330 Oak Shadow Ln Benton KY 42025-5494 |
| Practice Telephone | 2703954540 |
| Practice Fax Number | 2703957715 |
| Mailing Telephone | 2705278216 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 4311 | KY | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 85001477 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568835189 | Lisa Tack | Physician Assistant | 1001 Nw 13th St, #100, Boca Raton, FL 33486-2269 | 2015-11-04 |
| Street Address |
5131 US HIGHWAY 62 |
| City | CALVERT CITY |
| State | KY |
| Zip Code | 42029-8390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003969460 | Bradley A. Tack P.s.c. | Chiropractor | 5131 Us Highway 62, Calvert City, KY 42029-8390 | 2007-01-19 |
| 1316948839 | Charles Epstein | Chiropractor | 5131 Us Highway 62, Calvert City, KY 42029-8390 | 2005-08-09 |
| 1386645737 | Bradley A Tack | Chiropractor | 5131 Us Highway 62, Calvert City, KY 42029-8390 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619497179 | Sunetta Barrett | Registered Nurse | 563 East 5th Ave, Calvert City, KY 42029 | 2017-06-26 |
| 1649790882 | Cynthia Jill Landon | Registered Nurse | 3110 Hwy 95, Calvert City, KY 42029 | 2017-06-20 |
| 1285018564 | Jason Doughty | Physical Therapy Assistant | 186 Breeze Lane, Calvert City, KY 42029 | 2015-07-16 |
| 1104127125 | Gary Webster Smith | Dentist | 404 Fifth Ave., Calvert City, KY 42029 | 2010-11-08 |
| 1750694972 | Marshall County Health Department | Public Health or Welfare | 503 A 5th Ave S.e., Calvert City, KY 42029 | 2010-07-16 |
| 1578727491 | Jenny Sanderson Story | Speech-Language Pathologist | 110 Convalescent Dr, Calvert City, KY 42029 | 2008-07-10 |
| 1285897678 | Michele Christine Stariwat | Occupational Therapy Assistant | 110 Convalescent Drive, Calvert City, KY 42029 | 2008-07-07 |
| 1194986984 | Scott C Stephenson | Chiropractor | 1665 Oak Park Boulevard, Suite A, Calvert City, KY 42029 | 2008-06-24 |
| 1477735694 | John P Lyles Optometrist | Optometrist | 43 Industrial Parkway, Calvert City, KY 42029 | 2007-11-29 |
| 1528254299 | Andrea Norenne Jennings | Massage Therapist | 5119 U.S. Highway 62, Calvert City, KY 42029 | 2007-09-17 |
| Find all providers in zip 42029 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194986984 | Scott C Stephenson | Chiropractor | 1665 Oak Park Boulevard, Suite A, Calvert City, KY 42029 | 2008-06-24 |
| 1053413864 | Jacob Ryan Quint | Chiropractor | 1665 Oak Park Blvd., Calvert City, KY 42029 | 2006-09-02 |
| 1003969460 | Bradley A. Tack P.s.c. | Chiropractor | 5131 Us Highway 62, Calvert City, KY 42029-8390 | 2007-01-19 |
| 1316948839 | Charles Epstein | Chiropractor | 5131 Us Highway 62, Calvert City, KY 42029-8390 | 2005-08-09 |
| 1386645737 | Bradley A Tack | Chiropractor | 5131 Us Highway 62, Calvert City, KY 42029-8390 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023271 | Elizabeth Roth | Chiropractor | 3650 Boston Rd Ste 188, Lexington, KY 40514-1502 | 2020-11-04 |
| 1194332338 | Core Health Centers of Dry Ridge LLC | Chiropractor | 1113 Fashion Ridge Rd, Dry Ridge, KY 41035-9609 | 2020-09-30 |
| 1407461882 | Bryce Channing Fugate | Chiropractor | 511 Marsailles Rd, Versailles, KY 40383-1911 | 2020-09-11 |
| 1225667652 | Regency Chiropractic | Chiropractor | 171 W Lowry Ln Ste 164, Lexington, KY 40503-3006 | 2020-04-07 |
| 1447886247 | Matthew Scott Honchel | Chiropractor | 101 Citation Dr Ste A, Danville, KY 40422-9227 | 2020-03-12 |
| 1467087866 | Jenna Mekensie Turner | Chiropractor | 448 Lewis Hargett Cir Ste 220, Lexington, KY 40503-3596 | 2020-03-05 |
| 1376177956 | Spine Stop Glasgow, Pllc | Chiropractor | 1101 Cleveland Ave, Glasgow, KY 42141-1011 | 2020-02-24 |
| 1124650668 | Christina Ann Schlesinger | Chiropractor | 108 Cannons Ln, Louisville, KY 40206-2725 | 2020-02-12 |
| 1497387864 | Central City Chiropractic, Pllc | Chiropractor | 1731 W Everly Brothers Blvd, Central City, KY 42330-1833 | 2020-02-04 |
| 1942849179 | Tanner Evans | Chiropractor | 110b E 5th St, Benton, KY 42025-1118 | 2020-01-06 |
| Find all providers with the same taxonomy | ||||
| City | CALVERT CITY |
| Zip Code | 42029 |
Please comment or provide details below to improve the information on DR. LISA A TACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.