Organization Active NPI

Advanced Care Chiropractic and Rehab

  • Chiropractor
  • Johnson City, TN
National Provider Identifier
1013389469
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000001283 Issued in TN
Legal business name
ADVANCED CARE CHIROPRACTIC AND REHAB
Practice address
3043 Boones Creek Rd Ste 107
Johnson City, TN 37615-4959
Phone
(423) 929-2225
Fax
(888) 639-0839
NPI assigned
Oct 26, 2015
Last updated
Oct 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Authorized official

Name
Dr. Kevin Douglas Fielden, D.C.NPI 1891784146
Title
Chiropractic Physician
Phone
(423) 929-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000001283 TN Primary

Addresses

Primary practice location

3043 Boones Creek Rd Ste 107
Johnson City, TN 37615-4959

Mailing address

3043 Boones Creek Rd Ste 107
Johnson City, TN 37615-4959
Phone (423) 929-2225

Other identifiers 1

IdentifierTypeStateIssuer
3032514OtherBLUE CROSS BLUE SHIELD OF TENNESSEE

National Provider Directory

National Provider Directory

Locations

3043 Boones Creek Rd
Ste 107
Johnson City, TN 37615
Phone (423) 929-2225

Practitioners & affiliated clinicians

Practitioners 1

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": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1013389469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 BOONES CREEK RD STE 107",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154959",
            "telephone_number": "423-929-2225",
            "fax_number": "888-639-0839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 BOONES CREEK RD STE 107",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154959",
            "telephone_number": "423-929-2225",
            "fax_number": "888-639-0839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARE CHIROPRACTIC AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "FIELDEN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "423-929-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000001283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TENNESSEE",
            "identifier": "3032514",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.