Organization Active NPI

Patterson Chiropractic Clinic, PA

  • Chiropractor
  • Cleveland, MS
National Provider Identifier
1376605352
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
203 Issued in MS
Legal business name
PATTERSON CHIROPRACTIC CLINIC, PA
Practice address
110 E End St
Cleveland, MS 38732-2742
Phone
(662) 843-8712
Fax
(662) 843-0364
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Ray Patterson, D.C.NPI 1295897288
Title
President
Phone
(662) 843-8712

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 203 MS Primary

Addresses

Primary practice location

110 E End St
Cleveland, MS 38732-2742

Mailing address

110 E End St
Cleveland, MS 38732-2742
Phone (662) 843-8712

Other identifiers 1

IdentifierTypeStateIssuer
00114922MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376605352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E END ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322742",
            "telephone_number": "662-843-8712",
            "fax_number": "662-843-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E END ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322742",
            "telephone_number": "662-843-8712",
            "fax_number": "662-843-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTERSON CHIROPRACTIC CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-843-8712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00114922",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.