Organization Active NPI

Cornerstone Chiropractic, Inc.

  • Chiropractor
  • Knoxville, TN
National Provider Identifier
1245679109
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
TN 1877 Issued in TN
Legal business name
CORNERSTONE CHIROPRACTIC, INC.
Practice address
4465 Kingston Pike
Knoxville, TN 37919-5226
Phone
(865) 247-0458
Fax
(865) 588-1007
NPI assigned
Jun 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Authorized official

Name
Dr. John W. Edwards, D.C.NPI 1093842833
Title
Owner
Phone
(865) 247-0458

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 TN 1877 TN Primary

Addresses

Primary practice location

4465 Kingston Pike
Knoxville, TN 37919-5226

Mailing address

4465 Kingston Pike
Knoxville, TN 37919-5226
Phone (865) 247-0458

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130716000796 TN Part B Supplier - Clinic/Group Practice 0042450942 Receives reassigned benefits from 1 practitioner
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Locations

4465 Kingston Pike
Knoxville, TN 37919
Phone (865) 247-0458

Practitioners & affiliated clinicians

Practitioners 1

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": "1372032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1245679109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195226",
            "telephone_number": "865-247-0458",
            "fax_number": "865-588-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195226",
            "telephone_number": "865-247-0458",
            "fax_number": "865-588-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-247-0458",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "TN 1877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.