NPIMap

Organization Active NPI

Chiropractic Center of McComb

  • Chiropractor
  • McComb, MS
National Provider Identifier
1487847612
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
959 Issued in MS
Legal business name
CHIROPRACTIC CENTER OF MCCOMB
Practice address
150 Marion Ave
McComb, MS 39648-3620
Phone
(601) 684-9200
Fax
(601) 684-1198
NPI assigned
Aug 21, 2007
Last updated
Mar 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Dr. Marla V Hinckley, D.C.NPI 1083752646
Title
Chiropractor
Phone
(601) 684-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 959 MS Primary
Chiropractor 111N00000X 989 MS

Addresses

Primary practice location

150 Marion Ave
McComb, MS 39648-3620

Mailing address

150 Marion Ave
McComb, MS 39648-3620
Phone (601) 684-9200

Other identifiers 2

IdentifierTypeStateIssuer
451797377COtherMSBLUE CROSS
00120127MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120123000290 MS Part B Supplier - Clinic/Group Practice 6406023068 Receives reassigned benefits from 2 practitioners
Practice locations: McComb, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1487847612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483620",
            "telephone_number": "601-684-9200",
            "fax_number": "601-684-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483620",
            "telephone_number": "601-684-9200",
            "fax_number": "601-684-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC CENTER OF MCCOMB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "HINCKLEY",
        "authorized_official_first_name": "MARLA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "601-684-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "959",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "989",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "451797377C",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120127",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.