NPIMap

Organization Active NPI

Spinal Corrective Ctr

Doing business as Spinal Corrective Center

  • Chiropractor
  • Johnson City, TN
National Provider Identifier
1093336448
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SPINAL CORRECTIVE CTR
Doing business as
Spinal Corrective Center
Practice address
306 Sunset Dr Ste 100
Johnson City, TN 37604-2492
Phone
(423) 926-8304
Fax
(423) 926-5976
NPI assigned
Apr 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Craig Carroll Livesay, DCNPI 1598819021
Title
Owner
Phone
(423) 926-8304

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 1

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

Addresses

Primary practice location

306 Sunset Dr Ste 100
Johnson City, TN 37604-2492

Mailing address

306 Sunset Dr Ste 100
Johnson City, TN 37604-2492
Phone (423) 926-8304

Other names 1

  • Spinal Corrective Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220209000917 TN Part B Supplier - Clinic/Group Practice 9931592219 Receives reassigned benefits from 4 practitioners
Practice locations: Johnson City, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1093336448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 SUNSET DR STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042492",
            "telephone_number": "423-926-8304",
            "fax_number": "423-926-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 SUNSET DR STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042492",
            "telephone_number": "423-926-8304",
            "fax_number": "423-926-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL CORRECTIVE CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "LIVESAY",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "CARROLL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-926-8304",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spinal Corrective Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spinal Corrective Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.