Creekside Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR006622 Issued in GA

Legal business name

CREEKSIDE CHIROPRACTIC LLC

Practice address

5947 Holly Springs Pkwy
Suite 308
Holly Springs, GA 30188-2447

Phone

(770) 744-8393

NPI assigned

Nov 11, 2015

Last updated

Nov 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tracy Ivy James, D.C.

Title

Partner

Phone

(770) 744-8393

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447200000000",
    "number": "1376916452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5947 HOLLY SPRINGS PKWY",
            "address_2": "SUITE 308",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "301882447",
            "telephone_number": "770-744-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5947 HOLLY SPRINGS PKWY",
            "address_2": "SUITE 308",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "301882447",
            "telephone_number": "770-744-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-11",
        "last_updated": "2015-11-11",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "IVY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "770-744-8393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I354499",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "202I358649",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Brynne Campbell, PA-C
• Daquesha Capre Chever, D.O
• Sydney Anabel Colon, APRN-FNP
• Sarah Scott Cool
• Stacey Collene Cox, N.P.-C
• Creekside Family Chiropractic
• Shengchuan Dai, MD
• Jennifer Lynn Davenport, NP
• Alexandra Deister
• Lily Dlhosh, DC

• Chiropractor in Holly Springs, GA
• Providers in Holly Springs, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; 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.