Picayune Chiropractic Clinic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1093 Issued in MS

Legal business name

PICAYUNE CHIROPRACTIC CLINIC INC

Practice address

214 N Curran Ave
Suite E1
Picayune, MS 39466-4002

Phone

(601) 889-1633

Fax

(604) 889-1633

NPI assigned

May 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ricco Vito Impastato, D.C.

Title

Chiropractor

Phone

(601) 889-1633

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487601084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 N CURRAN AVE",
            "address_2": "SUITE E1",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394664002",
            "telephone_number": "601-889-1633",
            "fax_number": "601-889-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 N CURRAN AVE",
            "address_2": "SUITE E1",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394664002",
            "telephone_number": "601-889-1633",
            "fax_number": "604-889-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICAYUNE CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IMPASTATO",
        "authorized_official_first_name": "RICCO",
        "authorized_official_middle_name": "VITO",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "601-889-1633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Donnell Penton, FNP
• Victoria-Leigh Elizabeth Perkins, RBT
• Personal Pediatric Care of Picayune LLC
• Clara Annette Phillippe
• Phoenix Health, LLC
• Picayune Chiropractic, PLLC
• Picayune Clinic LLC
• Picayune Drug Co. North
• Picayune Drug Co., Inc.
• Picayune Drug Co., Inc.

• All providers in Picayune, MS
• Chiropractor in Mississippi

• 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.