NPIMap

Organization Active NPI

Family Life Chiropractic Center

  • Chiropractor
  • Blue Ridge, GA
National Provider Identifier
1265659155
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FAMILY LIFE CHIROPRACTIC CENTER
Practice address
351 E Highland St
Blue Ridge, GA 30513-4544
Phone
(706) 632-2707
Fax
(706) 632-2723
NPI assigned
Apr 20, 2007
Last updated
Aug 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Authorized official

Name
Dr. Stacey D Davis, D.C.NPI 1588793541
Title
Owner
Phone
(706) 632-2707

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 Primary

Addresses

Primary practice location

351 E Highland St
Blue Ridge, GA 30513-4544

Mailing address

PO Box 2671
Blue Ridge, GA 30513-0047
Phone (706) 632-2707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040503000295 GA Part B Supplier - Clinic/Group Practice 1951399781 Receives reassigned benefits from 3 practitioners
Practice locations: Blue Ridge, GA

National Provider Directory

National Provider Directory

Locations

351 E Highland St
Blue Ridge, GA 30513
Phone (706) 276-1099

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1265659155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2671",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305130047",
            "telephone_number": "706-632-2707",
            "fax_number": "706-632-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 E HIGHLAND ST",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134544",
            "telephone_number": "706-632-2707",
            "fax_number": "706-632-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-632-2707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.