Organization Active NPI

Dade County Chiropractic Center LLC

  • Chiropractor
  • Trenton, GA
National Provider Identifier
1184903965
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008825 Issued in GA
Legal business name
DADE COUNTY CHIROPRACTIC CENTER LLC
Practice address
12605 N Main St
Trenton, GA 30752-2220
Phone
(706) 657-7597
Fax
(706) 657-7597
NPI assigned
Aug 10, 2011
Last updated
Aug 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Authorized official

Name
Dr. James Cason Durham, D.C.NPI 1679860498
Title
Owner
Phone
(706) 657-7597

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 CHIR008825 GA Primary

Addresses

Primary practice location

12605 N Main St
Trenton, GA 30752-2220

Mailing address

PO Box 759
Trenton, GA 30752-0759
Phone (706) 657-7597

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111219000812 GA Part B Supplier - Clinic/Group Practice 9537334693 Receives reassigned benefits from 1 practitioner
Practice locations: Trenton, GA

National Provider Directory

National Provider Directory

Locations

12605 N Main St
Trenton, GA 30752
Phone (706) 657-7597

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312934400000",
    "number": "1184903965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 759",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307520759",
            "telephone_number": "706-657-7597",
            "fax_number": "706-657-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 N MAIN ST",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307522220",
            "telephone_number": "706-657-7597",
            "fax_number": "706-657-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DADE COUNTY CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-08-10",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-657-7597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.