Guernsey Chiropractic and Sports Injury Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2010013285 Issued in MO

Legal business name

GUERNSEY CHIROPRACTIC AND SPORTS INJURY CENTER LLC

Practice address

1704 Main St
Bethany, MO 64424-2064

Phone

(660) 425-3444

Fax

(660) 425-3044

NPI assigned

Dec 3, 2010

Last updated

Aug 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tina Forman

Title

Office Manager

Phone

(660) 425-3444

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

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.

• Caleb Guernsey, CALEB GUERNSEY

  • Chiropractor
  • Bethany, MO
  • NPI 1477872182
  Medicare reassignment NPD
• Kelly Jay Kadolph, D.C.

  • Sports Physician Chiropractor
  • Bethany, MO
  • NPI 1639114366
  NPD (past)

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1609178185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 MAIN ST",
            "city": "BETHANY",
            "state": "MO",
            "postal_code": "644242064",
            "telephone_number": "660-425-3444",
            "fax_number": "660-425-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 MAIN ST",
            "city": "BETHANY",
            "state": "MO",
            "postal_code": "644242064",
            "telephone_number": "660-425-3444",
            "fax_number": "660-425-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUERNSEY CHIROPRACTIC AND SPORTS INJURY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "660-425-3444"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2010013285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory A Dean, M.D.
• Deanna Rae Dinwiddie, LMSW
• Douglas Faulkner, RPH
• Gentry County Association for Retarded Citizens, Inc.
• Christopher Michael Gifford, D.O.
• Caleb Guernsey, CALEB GUERNSEY
• Terry E. Hall, M.D.
• Ashley Harding
• Amy B Harris
• Harrison County Community Hospital District (Bethany Medical Clinic)

• Chiropractor in Bethany, MO
• Providers in Bethany, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.