Organization Active NPI

McCallie Chiropractic & Rehabilitation Center PLLC

  • Chiropractor
  • Chattanooga, TN
National Provider Identifier
1275500571
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MCCALLIE CHIROPRACTIC & REHABILITATION CENTER PLLC
Practice address
920 McCallie Ave
Chattanooga, TN 37403-2724
Phone
(423) 752-7464
Fax
(423) 752-6079
NPI assigned
Mar 6, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Larry Douglas Adair, DCNPI 1558338855
Title
Chief Manager
Phone
(423) 752-7464

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 Primary

Addresses

Primary practice location

920 McCallie Ave
Chattanooga, TN 37403-2724

Mailing address

PO Box 11182
Chattanooga, TN 37401
Phone (423) 752-7464

Other identifiers 1

IdentifierTypeStateIssuer
3733097MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060404000077 TN Part B Supplier - Clinic/Group Practice 7012925944 Receives reassigned benefits from 1 practitioner
Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory

Locations

900 Georgia Ave
Chattanooga, TN 37402

920 McCallie Ave
Chattanooga, TN 37403
Phone (423) 752-7464

1924 Alcoa Hwy
Ste 600S
Knoxville, TN 37920
Phone (423) 752-6079

Practitioners & affiliated clinicians

Practitioners 2

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": "1141603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1275500571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11182",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37401",
            "telephone_number": "423-752-7464",
            "fax_number": "423-752-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032724",
            "telephone_number": "423-752-7464",
            "fax_number": "423-752-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCALLIE CHIROPRACTIC & REHABILITATION CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-06",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ADAIR",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "423-752-7464",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3733097",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.