The Chattanooga Spine and Wellness Institute, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

40410 Issued in TN

Legal business name

THE CHATTANOOGA SPINE AND WELLNESS INSTITUTE, INC

Practice address

1334 Mackey Branch Drive
Suite 103
Chattanooga, TN 37421-3471

Phone

(423) 296-2604

Fax

(423) 296-2607

NPI assigned

Oct 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Taylor, D.C.

Title

President

Phone

(423) 296-2604

Specialties & licenses 4

Addresses

Other names 2

• Southeast Center for Bone and Joint Doing business as
• Dalton Clinic of Chiropractic, Inc Former legal business name

Locations

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1043499700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 MACKEY BRANCH DRIVE",
            "address_2": "SUITE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213471",
            "telephone_number": "423-296-2604",
            "fax_number": "423-296-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 MACKEY BRANCH DRIVE",
            "address_2": "SUITE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213471",
            "telephone_number": "423-296-2604",
            "fax_number": "423-296-2607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1745 Phoenix Blvd Ste 335",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303495569",
            "country_code": "US",
            "telephone_number": "423-296-2604",
            "fax_number": "423-296-2607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE CHATTANOOGA SPINE AND WELLNESS INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-296-2604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2465",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TN",
            "license": "40410",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TN",
            "license": "52292",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "17939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Center for Bone and Joint",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dalton Clinic of Chiropractic, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• General Practice Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.