Emmanuel Ridge Chiropractic Services, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0972 Issued in MS

Legal business name

EMMANUEL RIDGE CHIROPRACTIC SERVICES, INC.

Practice address

4801 N State St Ste 116
Jackson, MS 39206-4825

Phone

(601) 845-3544

Fax

(601) 845-3636

NPI assigned

Oct 26, 2006

Last updated

Aug 22, 2020By 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

Mrs. Beatrice A Ezem, RN, CM,CLNC

Title

President,Ceo

Phone

(601) 845-3544

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609951847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 HIGHWAY 49 S STE P",
            "city": "FLORENCE",
            "state": "MS",
            "postal_code": "390739523",
            "telephone_number": "601-845-3544",
            "fax_number": "601-845-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 N STATE ST STE 116",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064825",
            "telephone_number": "601-845-3544",
            "fax_number": "601-845-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL RIDGE CHIROPRACTIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EZEM",
        "authorized_official_first_name": "BEATRICE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT,CEO",
        "authorized_official_telephone_number": "601-845-3544",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, CM,CLNC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "0972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John Blake Endris, FNP-C
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• Enduracare Acute Care Services LLC (Enduracare Acute Care Services Jackson)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.