Mediclinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

007116 Issued in GA

Legal business name

MEDICLINIC

Practice address

355 Upper Riverdale Rd
A8
Jonesboro, GA 31141

Phone

(770) 876-6972

NPI assigned

Apr 3, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Sara Badie, NA

Title

Billing

Phone

(770) 876-6972

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1215270699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 UPPER RIVERDALE RD STE# A-8",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "31141",
            "telephone_number": "770-876-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 UPPER RIVERDALE RD",
            "address_2": "A8",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "31141",
            "telephone_number": "770-876-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "BADIE",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "770-876-6972",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NA"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "007116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jasmine Merrell, OTR/L

• Chiropractor in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.