NPIMap

Organization Active NPI

Maywood Chiropractic Clinic

  • Chiropractor
  • Flowood, MS
National Provider Identifier
1598081895
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
124 Issued in MS
Legal business name
MAYWOOD CHIROPRACTIC CLINIC
Practice address
1000 Lakeland Square Ext
Suite 400
Flowood, MS 39232-7620
Phone
(601) 932-3855
Fax
(601) 932-6557
NPI assigned
Apr 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Authorized official

Name
Ms. Heather Tanner McLendon
Title
Office Manager
Phone
(601) 932-3855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 124 MS Primary

Addresses

Primary practice location

1000 Lakeland Square Ext
Suite 400
Flowood, MS 39232-7620

Mailing address

1000 Lakeland Square Ext
Suite 400
Flowood, MS 39232-7620
Phone (601) 932-3855

Other identifiers 2

IdentifierTypeStateIssuer
00115753MedicaidMS
302G351184OtherMSMEDICARE P-TAN

Other names 1

  • NORVILLE CHIROPRACTIC CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

1000 Lakeland Square Ext
Ste 400
Jackson, MS 39232
Phone (601) 932-3855

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1598081895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LAKELAND SQUARE EXT",
            "address_2": "SUITE 400",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327620",
            "telephone_number": "601-932-3855",
            "fax_number": "601-932-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAKELAND SQUARE EXT",
            "address_2": "SUITE 400",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327620",
            "telephone_number": "601-932-3855",
            "fax_number": "601-932-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYWOOD CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "MCLENDON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "TANNER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-932-3855",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115753",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P-TAN",
            "identifier": "302G351184",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORVILLE CHIROPRACTIC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.