Organization Active NPI

New Haven Chiropractic Clinic, LLC

  • Chiropractor
  • Greenwood, MS
National Provider Identifier
1366750606
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1146 Issued in MS
Legal business name
NEW HAVEN CHIROPRACTIC CLINIC, LLC
Practice address
1707 Strong Ave
Suite a
Greenwood, MS 38930-3923
Phone
(662) 453-2250
Fax
(662) 453-2280
NPI assigned
Sep 21, 2010
Last updated
Sep 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Authorized official

Name
Dr. Kimberly Jefferson, B.A.,D.C.NPI 1053647180
Title
Chiropractor
Phone
(662) 392-1608

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1146 MS Primary

Addresses

Primary practice location

1707 Strong Ave
Suite a
Greenwood, MS 38930-3923

Mailing address

PO Box 1661
Greenwood, MS 38935-1661
Phone (662) 453-2250

National Provider Directory

National Provider Directory

Locations

1707 Strong Ave
#A
Greenwood, MS 38930
Phone (662) 453-2250

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": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1366750606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1661",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351661",
            "telephone_number": "662-453-2250",
            "fax_number": "662-453-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 STRONG AVE",
            "address_2": "SUITE A",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389303923",
            "telephone_number": "662-453-2250",
            "fax_number": "662-453-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN CHIROPRACTIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "662-392-1608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "B.A.,D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.