Collegedale Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1767 Issued in TN

Legal business name

COLLEGEDALE CHIROPRACTIC PLLC

Practice address

9457 David Smith LN
Suite 105
Ooltewah, TN 37363-7292

Phone

(423) 238-4118

NPI assigned

Feb 24, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Gregory C Schrader, DCNPI 1568708261

Title

Sole Proprietor

Phone

(423) 238-4118

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Collegedale Physical Medicine, PLLC

  • Pain Clinic/Center
  • Ooltewah, TN
  • NPI 1811649056
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory C Schrader, DC

  • Chiropractor
  • Ooltewah, TN
  • NPI 1568708261
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1316487382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9457 DAVID SMITH LN",
            "address_2": "SUITE 105",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637292",
            "telephone_number": "423-238-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9457 DAVID SMITH LN",
            "address_2": "SUITE 105",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637292",
            "telephone_number": "423-238-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGEDALE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "SCHRADER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "423-238-4118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Chung, DDS
• Patricia Ruth Class, APRN, FNP
• Clarence Herbert Clifton III, DPT
• Lisa Lynn Clouzet, LPC, NCC
• Kimberly W. Coffey, PT
• Collegedale Family Dentistry P.C.
• Collegedale Physical Medicine, PLLC
• Ann Belton Collins, DO
• Complete Care Physical Therapy
• Paula Renee Connor, IBCLC

• Chiropractor in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.