Shuttleworth Chiropractic Centre PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0753 Issued in MS

Legal business name

SHUTTLEWORTH CHIROPRACTIC CENTRE PA

Practice address

665 East Pass Rd Ste 3
Gulfport, MS 39507

Phone

(228) 896-3002

Fax

(228) 897-1417

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark R Shuttleworth, DCNPI 1083786768

Title

Chiropractor

Phone

(228) 896-3002

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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.

• Mark Read Shuttleworth, DC

  • Chiropractor
  • Gulfport, MS
  • NPI 1083786768
  Medicare reassignment NPD Authorized official
• Clay Eugene Wilkins, D.C.

  • Chiropractor
  • Hot Springs Village, AR
  • NPI 1417144163
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1609948397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 EAST PASS RD STE 3",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "telephone_number": "228-896-3002",
            "fax_number": "228-897-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 EAST PASS RD STE 3",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "telephone_number": "228-896-3002",
            "fax_number": "228-897-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHUTTLEWORTH CHIROPRACTIC CENTRE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "SHUTTLEWORTH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "228-896-3002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "0753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115351",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Sherman
• Cynthia B. Shields, PT
• Donald W Shinskie, CRNA
• Sheila Lee Shipman, IDC
• Joseph P. Shrum, MD
• Mark Read Shuttleworth, DC
• Brittany Sick, RN
• Ibis D. Sigas, M.D.
• Carolyn C Signorine, OTR/L, CHT
• Haylee Sikes

• Chiropractor in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.