Revive Health Center and Spa

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR007723 Issued in GA

Legal business name

REVIVE HEALTH CENTER AND SPA

Practice address

6875 Hickory Rd Ste 110
Woodstock, GA 30188-2011

Phone

(770) 345-1111

Fax

(770) 345-1788

NPI assigned

Sep 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kellie Baxter, D.C.

Title

Chiropractor/Owner

Phone

(770) 345-1111

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1477749067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6875 HICKORY RD STE 110",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882011",
            "telephone_number": "770-345-1111",
            "fax_number": "770-345-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6875 HICKORY RD STE 110",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882011",
            "telephone_number": "770-345-1111",
            "fax_number": "770-345-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HEALTH CENTER AND SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "770-345-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.