Center for Physical Medicine

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1277 Issued in TN

Legal business name

CENTER FOR PHYSICAL MEDICINE

Doing business as

Center for Physical Medicine

Practice address

1822 Huntsville Hwy Ste D
Fayetteville, TN 37334-3788

Phone

(931) 438-0611

Fax

(931) 438-0622

NPI assigned

Mar 25, 2008

Last updated

Jul 10, 2012By 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

James Eric Deaton, D.C.

Title

Owner

Phone

(931) 438-0611

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CENTER FOR PHYSICAL MEDICINE Doing business as

Locations

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1053583674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 HUNTSVILLE HWY STE D",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373343788",
            "telephone_number": "931-438-0611",
            "fax_number": "931-438-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 HUNTSVILLE HWY STE D",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373343788",
            "telephone_number": "931-438-0611",
            "fax_number": "931-438-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "DEATON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-438-0611",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "3120641",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD4186",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTER FOR PHYSICAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Fayetteville, TN
• Providers in Fayetteville, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.