Gautier Chiropractic Group

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

415 Issued in MS

Legal business name

GAUTIER CHIROPRACTIC GROUP

Practice address

3105 Shaw Drive
Gautier, MS 39553-5507

Phone

(228) 202-5106

Fax

(228) 202-5107

NPI assigned

Jul 17, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Grover Dale Johnson, D.C.

Title

Director

Phone

(228) 202-5106

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1467707257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 SHAW DRIVE",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535507",
            "telephone_number": "228-202-5106",
            "fax_number": "228-202-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 SHAW DRIVE",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535507",
            "telephone_number": "228-202-5106",
            "fax_number": "228-202-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUTIER CHIROPRACTIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GROVER",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "228-202-5106",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Venus Gaddis, M.S.
• Noe Garcia
• Dorothy Mae Gary
• Meaghan Elizabeth Gates
• Alicia Gatz
• Gautier Dental Center P.a.
• Gautier Family Clinic, LLC
• Gautier Family Dental
• Gautier Wellness LLC
• Debra S Gautier, RN

• Chiropractor in Gautier, MS
• Providers in Gautier, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.