NPIMap

Organization Active NPI

Wellness Clinic of Rutledge

  • Chiropractor
  • Rutledge, GA
National Provider Identifier
1013106319
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005862 Issued in GA
Legal business name
WELLNESS CLINIC OF RUTLEDGE
Practice address
113 Fairplay St
Rutledge, GA 30663-2377
Phone
(706) 557-0211
Fax
(706) 557-0213
NPI assigned
Oct 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Dr. Michael Dean Hughes, DCNPI 1356467617
Title
President
Phone
(706) 557-0211

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 CHIR005862 GA Primary

Addresses

Primary practice location

113 Fairplay St
Rutledge, GA 30663-2377

Mailing address

113 Fairplay St
Rutledge, GA 30663-2377
Phone (706) 557-0211

Other names 1

  • Back to Wellness Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080303000182 GA Part B Supplier - Clinic/Group Practice 4789768672 Receives reassigned benefits from 4 practitioners
Practice locations: Rutledge, GA

National Provider Directory

National Provider Directory

Locations

113 Fairplay St
Rutledge, GA 30663
Phone (706) 557-0211

Practitioners & affiliated clinicians

Practitioners 4

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": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1013106319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 FAIRPLAY ST",
            "city": "RUTLEDGE",
            "state": "GA",
            "postal_code": "306632377",
            "telephone_number": "706-557-0211",
            "fax_number": "706-557-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 FAIRPLAY ST",
            "city": "RUTLEDGE",
            "state": "GA",
            "postal_code": "306632377",
            "telephone_number": "706-557-0211",
            "fax_number": "706-557-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CLINIC OF RUTLEDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-557-0211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back to Wellness Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rutledge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.