Individual provider Active NPI

Nikolas Ramone Chillies, D.C.

  • Chiropractor
  • Olive Branch, MS
National Provider Identifier
1629010467
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1092 Issued in MS
Practice address
6253 Goodman Rd
Suite a & B
Olive Branch, MS 38654-9391
Phone
(662) 890-0012
Fax
(662) 890-0522
NPI assigned
Jun 12, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1092 MS Primary

Addresses

Primary practice location

6253 Goodman Rd
Suite a & B
Olive Branch, MS 38654-9391

Mailing address

6253 Goodman Rd
Suite a & B
Olive Branch, MS 38654-9391
Phone (662) 890-0012

Other identifiers 5

IdentifierTypeStateIssuer
5706402OtherMSFIRST HEALTH PROVIDER ID
0111474OtherMSCIGNA PROVIDER ID
7696844OtherMSAETNA PROVIDER ID
4131570OtherTNBCBS TN PROVIDER ID
701292OtherMSUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060705000188 MS Practitioner - Chiropractic 2961414230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7164 Hacks Cross Rd
Suite 110
Olive Branch, MS 38654-3907
Phone (662) 420-7073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Chiro Place of Collierville PLLC Chiropractor PastSince Sep 22, 2012 Accepting new patients
Mid-South Chiropractic, LLC Chiropractor Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629010467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6253 GOODMAN RD",
            "address_2": "SUITE A & B",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386549391",
            "telephone_number": "662-890-0012",
            "fax_number": "662-890-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6253 GOODMAN RD",
            "address_2": "SUITE A & B",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386549391",
            "telephone_number": "662-890-0012",
            "fax_number": "662-890-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILLIES",
        "first_name": "NIKOLAS",
        "middle_name": "RAMONE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PROVIDER ID",
            "identifier": "5706402",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER ID",
            "identifier": "0111474",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "7696844",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN PROVIDER ID",
            "identifier": "4131570",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "701292",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.