South Georgia Upper Cervical Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR009210 Issued in GA

Legal business name

SOUTH GEORGIA UPPER CERVICAL CHIROPRACTIC, LLC

Practice address

2935 N Ashley St
Ste 109
Valdosta, GA 31602-1777

Phone

(229) 469-4069

Fax

(229) 469-4069

NPI assigned

Mar 25, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Clinton McWilliams Sheffield, D.C.NPI 1609292895

Title

Doctor of Chiropractic/Owner

Phone

(229) 469-4069

Specialties & licenses 1

Addresses

Other names 1

• South Georgia Upper Cervical Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Clinton McWilliams Sheffield, D.C.

  • Chiropractor
  • Valdosta, GA
  • NPI 1609292895
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1215354501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 N ASHLEY ST",
            "address_2": "STE 109",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021777",
            "telephone_number": "229-469-4069",
            "fax_number": "229-469-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 N ASHLEY ST",
            "address_2": "STE 109",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021777",
            "telephone_number": "229-469-4069",
            "fax_number": "229-469-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA UPPER CERVICAL CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "SHEFFIELD",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "MCWILLIAMS",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC/OWNER",
        "authorized_official_telephone_number": "229-469-4069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Georgia Upper Cervical Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Valdosta, GA
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.