NPIMap

Organization Active NPI

Sheridan Chiropractic Clinic, P.a.

  • Chiropractor
  • Sheridan, AR
National Provider Identifier
1467612119
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1213 Issued in AR
Legal business name
SHERIDAN CHIROPRACTIC CLINIC, P.A.
Practice address
12 Opportunity Dr
Sheridan, AR 72150-9185
Phone
(870) 942-8014
NPI assigned
Jun 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Richard F Johnson, D.C.
Title
Chiropractor
Phone
(870) 942-8014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1213 AR Primary

Addresses

Primary practice location

12 Opportunity Dr
Sheridan, AR 72150-9185

Mailing address

12 Opportunity Dr
Sheridan, AR 72150-9185
Phone (870) 942-8014

Other identifiers 1

IdentifierTypeStateIssuer
59723OtherARBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

12 Opportunity Dr
Sheridan, AR 72150
Phone (870) 942-8014

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1467612119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 OPPORTUNITY DR",
            "city": "SHERIDAN",
            "state": "AR",
            "postal_code": "721509185",
            "telephone_number": "870-942-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 OPPORTUNITY DR",
            "city": "SHERIDAN",
            "state": "AR",
            "postal_code": "721509185",
            "telephone_number": "870-942-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN CHIROPRACTIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "870-942-8014",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "59723",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.