Pine Mountain Chiropractic Center, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

2301000RN Issued in GA

Legal business name

PINE MOUNTAIN CHIROPRACTIC CENTER, LLC

Practice address

624 N Main Ave
Pine Mountain, GA 31822-2403

Phone

(706) 663-8801

NPI assigned

Aug 22, 2007

Last updated

Aug 22, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kim W. Russell, MANAGING MEMBER

Title

Office Manager

Phone

(706) 663-8801

Specialties & licenses 1

Addresses

Locations

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.

• Jeffery A. Russell, DC

  • Chiropractor
  • Pine Mountain, GA
  • NPI 1427122951
  NPD (past)

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1023201217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 N MAIN AVE",
            "address_2": "P.O. BOX 1690",
            "city": "PINE MOUNTAIN",
            "state": "GA",
            "postal_code": "318222403",
            "telephone_number": "706-663-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 N MAIN AVE",
            "city": "PINE MOUNTAIN",
            "state": "GA",
            "postal_code": "318222403",
            "telephone_number": "706-663-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE MOUNTAIN CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-663-8801",
        "authorized_official_credential": "MANAGING MEMBER"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "GA",
            "license": "2301000RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JDF Corporation (U Save It Pharmacy Pine Mountain LTC)
• JDF Corporation (U Save It Pharmacy-Pine Mountain)
• John Christian Lowery, DMD
• Alexandra Lynch
• Dustin Petry, DMD
• Pine Mountain Eye Care
• Pine Mountain Family Dentistry, LLC
• Pine Mountain Pharmacy, Inc
• Veta Rhonda Rodriguez, MS CHRISTIAN COUNSEL
• Jeffery A. Russell, DC

• Health Service Clinic/Center in Pine Mountain, GA
• Providers in Pine Mountain, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.