Organization Active NPI

Patterson Family Chiropractic Clinic LLC

  • Chiropractor
  • Cartersville, GA
National Provider Identifier
1255629069
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIROO8815 Issued in GA
Legal business name
PATTERSON FAMILY CHIROPRACTIC CLINIC LLC
Practice address
1010 N Tennessee St
Suite Number 116
Cartersville, GA 30120-8525
Phone
(770) 383-9605
Fax
(770) 383-9606
NPI assigned
Jul 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Authorized official

Name
Dr. Mark A Patterson, D.C.NPI 1144513789
Title
President
Phone
(770) 383-9605

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 CHIROO8815 GA Primary

Addresses

Primary practice location

1010 N Tennessee St
Suite Number 116
Cartersville, GA 30120-8525

Mailing address

1010 N Tennessee St
Suite Number 116
Cartersville, GA 30120-8525
Phone (770) 383-9605

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110801000154 GA Part B Supplier - Clinic/Group Practice 3274701883 Receives reassigned benefits from 1 practitioner
Practice locations: Cartersville, GA

National Provider Directory

National Provider Directory

Locations

1010 N Tennessee St
Ste 116
Cartersville, GA 30120
Phone (770) 383-7605

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": "1310515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1255629069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N TENNESSEE ST",
            "address_2": "SUITE NUMBER 116",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208525",
            "telephone_number": "770-383-9605",
            "fax_number": "770-383-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N TENNESSEE ST",
            "address_2": "SUITE NUMBER 116",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208525",
            "telephone_number": "770-383-9605",
            "fax_number": "770-383-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTERSON FAMILY CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-383-9605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIROO8815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.