Organization Active NPI

Elevation Chiropractic PLLC

  • Chiropractor
  • Clarksville, TN
National Provider Identifier
1043847593
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ELEVATION CHIROPRACTIC PLLC
Practice address
1825 Madison St Ste D
Clarksville, TN 37043-6589
Phone
(931) 444-1236
NPI assigned
Mar 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Authorized official

Name
Dr. Jakob Slater, DCNPI 1770110223
Title
Owner
Phone
(931) 444-1236

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 Primary

Addresses

Primary practice location

1825 Madison St Ste D
Clarksville, TN 37043-6589

Mailing address

1825 Madison St Ste D
Clarksville, TN 37043-6589
Phone (931) 444-1236

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200406002309 TN Part B Supplier - Clinic/Group Practice 2466881834 Receives reassigned benefits from 1 practitioner
Practice locations: Clarksville, TN

National Provider Directory

National Provider Directory

Locations

1825 Madison St
Ste D
Clarksville, TN 37043
Phone (931) 444-1236

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": "1585094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1043847593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 MADISON ST STE D",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436589",
            "telephone_number": "931-444-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MADISON ST STE D",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436589",
            "telephone_number": "931-444-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATION CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "SLATER",
        "authorized_official_first_name": "JAKOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-444-1236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.