Organization Active NPI

Back to Health Chiropractic, LLC

  • Chiropractor
  • Cookeville, TN
National Provider Identifier
1053564583
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000002258 Issued in TN
Legal business name
BACK TO HEALTH CHIROPRACTIC, LLC
Practice address
419 E Broad St
Cookeville, TN 38501-3339
Phone
(931) 372-2225
Fax
(931) 372-2338
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Dr. Melissa Shawn Hall, D.C.
Title
Owner / Doctor
Phone
(931) 372-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC0000002258 TN Primary

Addresses

Primary practice location

419 E Broad St
Cookeville, TN 38501-3339

Mailing address

419 E Broad St
Cookeville, TN 38501-3339
Phone (931) 372-2225

Other identifiers 2

IdentifierTypeStateIssuer
3670112MedicaidTN
36701121MedicaidTN

National Provider Directory

National Provider Directory

Locations

419 E Broad St
Cookeville, TN 38501
Phone (931) 372-2225

848 N Jefferson Ave
Cookeville, TN 38501
Phone (931) 854-0966

103 W Main St
Ste B
Cookeville, TN 38506
Phone (931) 537-2447

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": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1053564583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 E BROAD ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013339",
            "telephone_number": "931-372-2225",
            "fax_number": "931-372-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E BROAD ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013339",
            "telephone_number": "931-372-2225",
            "fax_number": "931-372-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO HEALTH CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER / DOCTOR",
        "authorized_official_telephone_number": "931-372-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000002258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3670112",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36701121",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.