Active NPI
Back to Health Chiropractic, LLC
- Chiropractor
- Cookeville, TN
National Provider Identifier
1053564583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC0000002258
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3670112 | Medicaid | TN | |
| 36701121 | Medicaid | TN |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Chiropractor
- Nashville, TN
- NPI 1912035643
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.