Organization Active NPI

Fort Campbell Chiropractic PLLC

  • Chiropractor
  • Clarksville, TN
National Provider Identifier
1265983639
Registry record updated May 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000002440 Issued in TN
Legal business name
FORT CAMPBELL CHIROPRACTIC PLLC
Practice address
1881 Fort Campbell Blvd
Suite B
Clarksville, TN 37042-5109
Phone
(931) 920-0077
NPI assigned
Oct 20, 2016
Last updated
May 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2017

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

Authorized official

Name
Mr. John Y Curtis, D.C.NPI 1679889604
Title
Owner
Phone
(931) 920-0077

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
Chiropractor 111N00000X DC0000002440 TN Primary

Addresses

Primary practice location

1881 Fort Campbell Blvd
Suite B
Clarksville, TN 37042-5109

Mailing address

1881 Fort Campbell Blvd
Suite B
Clarksville, TN 37042-5109
Phone (931) 920-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170606001939 TN Part B Supplier - Clinic/Group Practice 5991072332 Receives reassigned benefits from 1 practitioner
Practice locations: Clarksville, TN

National Provider Directory

National Provider Directory

Locations

1881 Fort Campbell Blvd
Ste B
Clarksville, TN 37042
Phone (931) 920-0077

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495065600000",
    "number": "1265983639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 FORT CAMPBELL BLVD",
            "address_2": "SUITE B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370425109",
            "telephone_number": "931-920-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 FORT CAMPBELL BLVD",
            "address_2": "SUITE B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370425109",
            "telephone_number": "931-920-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT CAMPBELL CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2017-05-18",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-920-0077",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000002440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2017; 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.