NPIMap

Organization Active NPI

Family Chiropractic Complex

  • Chiropractor
  • Shelbyville, TN
National Provider Identifier
1295830610
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
472 Issued in TN
Legal business name
FAMILY CHIROPRACTIC COMPLEX
Practice address
1509 N Main St
Shelbyville, TN 37160-2323
Phone
(931) 247-1075
Fax
(931) 735-6290
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Marilyn R Everett, D.C.NPI 1720003221
Title
Director/Officer
Phone
(931) 685-0040

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 472 TN Primary

Addresses

Primary practice location

1509 N Main St
Shelbyville, TN 37160-2323

Mailing address

1509 N Main St
Shelbyville, TN 37160-2323
Phone (931) 247-1075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040106000387 TN Part B Supplier - Clinic/Group Practice 4981503273 Receives reassigned benefits from 2 practitioners
Practice locations: Shelbyville, TN

National Provider Directory

National Provider Directory

Locations

1114 N Main St
Ste A
Shelbyville, TN 37160
Phone (931) 652-9369

Practitioners & affiliated clinicians

Practitioners 11

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": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1295830610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 N MAIN ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602323",
            "telephone_number": "931-247-1075",
            "fax_number": "931-735-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 N MAIN ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602323",
            "telephone_number": "931-247-1075",
            "fax_number": "931-735-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHIROPRACTIC COMPLEX",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "931-685-0040",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.