Wyatt Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2098 Issued in TN

Legal business name

WYATT CHIROPRACTIC

Practice address

170 Holiday Dr
Clarksville, TN 37040-5023

Phone

(931) 802-6711

Fax

(931) 802-6712

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Mark Wyatt, DC

Title

Owner/Chiropractor

Phone

(931) 802-6711

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1508393398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 HOLIDAY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405023",
            "telephone_number": "931-802-6711",
            "fax_number": "931-802-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 HOLIDAY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405023",
            "telephone_number": "931-802-6711",
            "fax_number": "931-802-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "931-802-6711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000630607",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deasia Wright
• Jessica Leann Wright, RBT
• Suzanne Wright
• Alec Wroblewski
• Paige Taylor Wulff, FNP-C
• Amanda Wyatt
• Gara Wyatt, BS, RBT
• Mark Andrew Wyatt, DC
• Susannah Schrecker Wyatt
• Taylor Delaney Wyatt, DMD MSD

• Chiropractor in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.