Organization Active NPI

Source Chiropractic, PLLC

  • Chiropractor
  • Clarksville, TN
National Provider Identifier
1295036218
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SOURCE CHIROPRACTIC, PLLC
Practice address
1716 Memorial Dr
Clarksville, TN 37043-4542
Phone
(931) 591-3740
NPI assigned
Nov 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Authorized official

Name
Cindy A Morrey, D.C.NPI 1497056410
Title
Chief Manager
Phone
(931) 591-3740

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

1716 Memorial Dr
Clarksville, TN 37043-4542

Mailing address

1990 Madison St Ste 101
Clarksville, TN 37043-5002
Phone (931) 591-3740

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110208000604 TN Part B Supplier - Clinic/Group Practice 1153501127 Receives reassigned benefits from 3 practitioners
Practice locations: Clarksville, TN

National Provider Directory

National Provider Directory

Locations

1477 Dover Rd
Ste D
Clarksville, TN 37042
Phone (931) 591-3740

Practitioners & affiliated clinicians

Practitioners 3

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": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1295036218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 MADISON ST STE 101",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435002",
            "telephone_number": "931-591-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 MEMORIAL DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434542",
            "telephone_number": "931-591-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "MORREY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "931-591-3740",
        "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 Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.