Organization Active NPI

Cabot Chiropractic Clinic

  • Chiropractor
  • Cabot, AR
National Provider Identifier
1013084367
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1283 Issued in AR
Legal business name
CABOT CHIROPRACTIC CLINIC
Practice address
803 W Locust St
Cabot, AR 72023
Phone
(501) 843-3545
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Brenda Lee ThielemierNPI 1164406070
Title
Chiropractor
Phone
(501) 843-3545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1283 AR Primary

Addresses

Primary practice location

803 W Locust St
Cabot, AR 72023

Mailing address

PO Box 1120
Cabot, AR 72023
Phone (501) 843-3545

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100528000306 AR Part B Supplier - Clinic/Group Practice 2264561372 Receives reassigned benefits from 1 practitioner
Practice locations: Cabot, AR

National Provider Directory

National Provider Directory

Locations

803 W Locust St
Cabot, AR 72023
Phone (501) 843-3545

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013084367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1120",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "72023",
            "telephone_number": "501-843-3545",
            "fax_number": "501-843-3547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 W LOCUST ST",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "72023",
            "telephone_number": "501-843-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABOT CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THIELEMIER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "501-843-3545",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabot, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.