Matthews Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1015 Issued in MS

Legal business name

MATTHEWS CHIROPRACTIC CLINIC

Practice address

4515 Office Park Drive
Jackson, MS 39206

Phone

(601) 366-9005

NPI assigned

Jul 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Endre Dejuan Matthews

Title

Owner

Phone

(601) 366-9005

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1194955484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 OFFICE PARK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392066017",
            "telephone_number": "601-366-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 OFFICE PARK DRIVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39206",
            "telephone_number": "601-366-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEWS CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "ENDRE",
        "authorized_official_middle_name": "DEJUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-366-9005",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125438",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip Massey
• Paul Bernard Matens, LCSW
• Sara Matheson
• Tricia Roy Mathias, R.D.
• Sara Taylor Mathis
• Allison Carol Matthews, OTR/L
• Amanda Catherine Matthews
• Michael Matthews II
• Reagan Bartley Matze, LPC
• Maurice James Ophthalmology, PA

• Chiropractor in Jackson, MS
• Providers in Jackson, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.