DC Direct – Chiropractor in Southaven, MS

Key facts

NPI: 1124368071
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
Legal business name: DC DIRECT
Practice address: 8332 Park Pike
Southaven, MS 38671-7304
Phone: (901) 486-3559
NPI assigned: Feb 28, 2013
Organization subpart: No

Authorized official

Name: Dr. Patrick John Kelly, DC NPI 1548277957
Title: Owner
Phone: (901) 486-3559

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Patrick John Kelly, DC Chiropractor · Southaven, MS · NPI 1548277957

NPD (past) Authorized official CHIROPRACTOR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193400000X SINGLE SPECIALTY GROUP	111N00000X			Yes

Addresses

Primary practice location

8332 Park Pike
Southaven, MS 38671-7304

Mailing address

8332 Park Pike
Southaven, MS 38671-7304
Phone (901) 486-3559

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 28, 2013.

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1124368071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8332 PARK PIKE",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386717304",
            "telephone_number": "901-486-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8332 PARK PIKE",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386717304",
            "telephone_number": "901-486-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DC DIRECT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-486-3559",
        "authorized_official_name_prefix": "Dr.",
        "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": []
}

Other providers in Southaven, MS

All providers in Southaven, MS · Chiropractor in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.