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Active NPI 1629018320 Individual Practitioner Female Practitioner

Dr. Kelly J. Roush Icenhower , DC

Chiropractor • Gallipolis, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Kelly Roush Icenhower, DC is a certified Chiropractor practicing in Gallipolis, OH. With approximately 30 years of clinical experience since graduating from Palmer College Chiropractic - West Sunnyvale in 1996, Dr. Roush Icenhower delivers high-quality medical care to the local community at 1051 4TH AVE.

Dr. Roush Icenhower is affiliated with Holzer Clinic Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include chiropractic manipulative treatment, 1-2 spinal regions, chiropractic manipulative treatment, 3-4 spinal regions. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1051 4th Ave

Gallipolis, OH 456311612

Telephone 7404465244
Fax 7404465565
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Palmer College Chiropractic - West Sunnyvale

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Gallipolis, OH

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
30 Yrs +6.8 yrs vs City Avg
City Avg: 23.2 Yrs
State Avg: 24.4 Yrs
Regional Practice Density
7 Specialists

Practicing in Gallipolis, OH (2830 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
80.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Roush Icenhower (30 Years) 30 Yrs
Gallipolis Specialty Average (23.2 Years) 23.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
98940 Chiropractic manipulative treatment, 1-2 spinal regions
88 26 $133.00 $25.56

Medical Specialties & State Licenses

CMS Verified: 2020-07-01
Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License OH 2510

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.

Chiropractor

NUCC Taxonomy Code: 111N00000X

State License WV 2510

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
2026677 (OH)
Medicaid State Provider ID
0132242000 (WV)
Commercial Insurance / Payer ID Rr Medicare
350039394
Commercial Insurance / Payer ID Mountain State Bcbs
001714092
Commercial Insurance / Payer ID Caresource Medicaid
310917085149 (OH)
Commercial Insurance / Payer ID Anthem Bcbs
000000007692
Commercial Insurance / Payer ID Unison Medicaid
000000185276 (OH)

Hospital & Practice Group Affiliations

Holzer Clinic Llc

100 Jackson Pike, Gallipolis, OH 456311560

Phone: 7404465050

Holzer Clinic Llc

2605 Jackson Ave, Point Pleasant, WV 255501615

Phone: 3046754498

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Nancy Mullins , PT

Physical Therapist

NPI 1023039781

Physical Therapist

Joey Baker , PT

Physical Therapist

NPI 1083634422

Physical Therapist

Ronnie Morrison , LPTA

Physical Therapy Assistant

NPI 1134140890

Licensed Physical Therapist Assistant

Lori Scott , PT

Physical Therapist

NPI 1134463185

Physical Therapist

Andrea Roush , OT

Occupational Therapist

NPI 1205170370

Occupational Therapist

Haley Dombrow , PT

Physical Therapist

NPI 1215827845

Physical Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
👤
Provider Name / Credentials Updated July 01, 2020

Recorded as KELLY ROUSH ICENHOWER, DC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2020

Chiropractor (License #2510 in WV)

NPI Profile Active February 09, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location February 09, 2015

Registered at 1051 4TH AVE, GALLIPOLIS, OH 456311612 (Tel: 7404465244)

📍
Updated Business Mailing Address February 09, 2015

Registered at 90 JACKSON PIKE, GALLIPOLIS, OH 456311560 (Tel: 7404465244)

👤
Provider Name / Credentials Updated February 09, 2015

Recorded as KELLY ROUSH, DC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 09, 2015

Chiropractor (License #2510 in OH)

🟢
Initial NPI Registration & Enumeration June 08, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629018320
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 08, 2006
Last Update: July 01, 2020
Sole Proprietor: No

Mailing Address

90 Jackson Pike

Gallipolis, OH 456311560

Phone: 7404465244

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.