Organization Active NPI

Perry County Chiropractic, LLC

  • Chiropractor
  • Perryville, AR
National Provider Identifier
1184103376
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16033 Issued in AR
Legal business name
PERRY COUNTY CHIROPRACTIC, LLC
Doing business as
Perry County Chiropractic
Practice address
130 Houston Ave
Perryville, AR 72126-9451
Phone
(501) 889-5555
Fax
(501) 851-6495
NPI assigned
Aug 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Authorized official

Name
Dr. Tray Robert Fowler, D.C.
Title
Chiropractor/Partner
Phone
(214) 632-9022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 16033 AR Primary

Addresses

Primary practice location

130 Houston Ave
Perryville, AR 72126-9451

Mailing address

103 Park Dr
Maumelle, AR 72113-7407
Phone (501) 851-6685

Other names 1

  • Perry County Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

103 Park Dr
Maumelle, AR 72113
Phone (501) 851-6685

130 Houston Ave
Perryville, AR 72126
Phone (501) 889-5555

Practitioners & affiliated clinicians

Practitioners 3

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": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541980800000",
    "number": "1184103376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PARK DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137407",
            "telephone_number": "501-851-6685",
            "fax_number": "501-851-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HOUSTON AVE",
            "city": "PERRYVILLE",
            "state": "AR",
            "postal_code": "721269451",
            "telephone_number": "501-889-5555",
            "fax_number": "501-851-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY COUNTY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-11-12",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "TRAY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CHIROPRACTOR/PARTNER",
        "authorized_official_telephone_number": "214-632-9022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry County Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perryville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; 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.