Crossroads Wellness PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CROSSROADS WELLNESS PC

Doing business as

Central Georgia Clinic of Chiropractic

Practice address

120 Jackson St Ste C
Swainsboro, GA 30401-3160

Phone

(478) 268-9011

Fax

(478) 268-9151

NPI assigned

May 1, 2019

Last updated

Aug 7, 2019By 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

Dr. David Jackson Davis III, DCNPI 1225436470

Title

Owner

Phone

(478) 268-9011

Specialties & licenses 1

Addresses

Other names 1

• Central Georgia Clinic of Chiropractic Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• David J Davis III, D.C.

  • Chiropractor
  • Clearwater, FL
  • NPI 1225436470

  GA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565136000000",
    "number": "1639733041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 JACKSON ST STE C",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013160",
            "telephone_number": "478-268-9011",
            "fax_number": "478-268-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 JACKSON ST STE C",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013160",
            "telephone_number": "478-268-9011",
            "fax_number": "478-268-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-08-07",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-268-9011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "centralgeorgiaclinc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office Email",
            "address_1": "120 Jackson St Ste C",
            "city": "Swainsboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304013160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Central Georgia Clinic of Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Georgia Clinic of Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William F Connor, PT
• Kimberly Page Cooper, SLP
• Janet Costley, RN
• Debra L Crawley-Mataosky, MD
• David W Crooke, LPC
• Lydia Lee Daley, PMHNP, BC
• Suffearria Makia Daniels-Ellison, NURSE PRACTITIONER
• Debbie Jean Davis, RN
• Bobby Lee Derrick, MD
• Vinh Dong, MD

• Chiropractor in Swainsboro, GA
• Providers in Swainsboro, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.