Johnson City Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

JOHNSON CITY CHIROPRACTIC LLC

Doing business as

Johnson City Chiropractic

Practice address

505 E. Main St.
Johnson City, TX 78636

Phone

(830) 868-7770

NPI assigned

Apr 29, 2022

Last updated

Apr 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George Mark Shannan, DCNPI 1548374127

Title

Owner, Sole Member

Phone

(830) 868-7770

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Johnson City Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

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, and the practitioner matching its NPPES authorized official.

• George Mark Shannan

  • Chiropractor
  • Austin, TX
  • NPI 1548374127
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1265177745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E. MAIN ST.",
            "city": "JOHNSON CITY",
            "state": "TX",
            "postal_code": "78636",
            "telephone_number": "830-868-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E. MAIN ST.",
            "city": "JOHNSON CITY",
            "state": "TX",
            "postal_code": "78636",
            "telephone_number": "830-868-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON CITY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-14",
        "status": "A",
        "authorized_official_last_name": "SHANNAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER, SOLE MEMBER",
        "authorized_official_telephone_number": "830-868-7770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1548374127",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson City Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark D. Ellis, N.P.
• Jovawna Dawn Ellison-Hubbard, MSN,APRN,FNP-BC
• John Phillip Frasure, PA-C
• Mary Kathryn Hagemeier, D.D.S.
• Hamilton County Hospital District (Avir at Johnson City)
• Kristi Maki
• Paul Jay McKee, M.D.
• Medical Pumps & Supplies, Inc
• North Blanco County Emergency Medical Services, Inc. (North Blanco County EMS)
• Brandi Phenix, MS, CCC-SLP

• Chiropractor in Johnson City, TX
• Providers in Johnson City, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.