Organization Active NPI

Crowley Chiropractic Clinic, P.C.

  • Chiropractor
  • Brunswick, GA
National Provider Identifier
1073738522
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005978 Issued in GA
Legal business name
CROWLEY CHIROPRACTIC CLINIC, P.C.
Practice address
597 Palisade Dr
Brunswick, GA 31523-8208
Phone
(912) 265-2129
Fax
(912) 265-2605
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tina Louise Crowley, D. C.NPI 1902020696
Title
Chiropractor
Phone
(912) 265-2129

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIR005978 GA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIR006507 GA

Addresses

Primary practice location

597 Palisade Dr
Brunswick, GA 31523-8208

Mailing address

597 Palisade Dr
Brunswick, GA 31523-8208
Phone (912) 265-2129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000619 GA Part B Supplier - Clinic/Group Practice 5991619439 Receives reassigned benefits from 2 practitioners
Practice locations: Brunswick, GA

National Provider Directory

National Provider Directory

Locations

597 Palisade Dr
Brunswick, GA 31523
Phone (912) 265-2129

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073738522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 PALISADE DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315238208",
            "telephone_number": "912-265-2129",
            "fax_number": "912-265-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 PALISADE DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315238208",
            "telephone_number": "912-265-2129",
            "fax_number": "912-265-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWLEY CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROWLEY",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "912-265-2129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005978",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006507",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.