NPIMap

Organization Active NPI

Healthsource Chiropractic of Spanish Fort LLC

  • Chiropractor
  • Spanish Fort, AL
National Provider Identifier
1063962124
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2427 Issued in AL
Legal business name
HEALTHSOURCE CHIROPRACTIC OF SPANISH FORT LLC
Practice address
10179 Eastern Shore Dr
Suite 102
Spanish Fort, AL 36527-3302
Phone
(251) 391-9341
Fax
(251) 625-4488
NPI assigned
Oct 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Authorized official

Name
Jim Rachwitz
Title
President, Owner
Phone
(251) 625-4777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2427 AL Primary

Addresses

Primary practice location

10179 Eastern Shore Dr
Suite 102
Spanish Fort, AL 36527-3302

Mailing address

10179 Eastern Shore Dr
Suite 102
Spanish Fort, AL 36527-3302
Phone (251) 391-9341

National Provider Directory

National Provider Directory

Locations

10179 Eastern Shore Dr
Ste 102
Spanish Fort, AL 36527
Phone (205) 746-7183

Practitioners & affiliated clinicians

Practitioners 2

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": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1063962124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10179 EASTERN SHORE DR",
            "address_2": "SUITE 102",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365273302",
            "telephone_number": "251-391-9341",
            "fax_number": "251-625-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10179 EASTERN SHORE DR",
            "address_2": "SUITE 102",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365273302",
            "telephone_number": "251-391-9341",
            "fax_number": "251-625-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE CHIROPRACTIC OF SPANISH FORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "RACHWITZ",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "251-625-4777"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fort, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.