NPIMap

Organization Active NPI

Northeast Chiropractic Clinic, Inc.

  • Chiropractor
  • Ridgeland, MS
National Provider Identifier
1649646027
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
655 Issued in MS
Legal business name
NORTHEAST CHIROPRACTIC CLINIC, INC.
Practice address
575 Highway 51
Ridgeland, MS 39157-2593
Phone
(601) 856-2383
Fax
(601) 856-3955
NPI assigned
Aug 19, 2015
Last updated
Apr 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Authorized official

Name
Mrs. Elisa Gamble
Title
Office Manager
Phone
(601) 856-2383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 655 MS Primary

Addresses

Primary practice location

575 Highway 51
Ridgeland, MS 39157-2593

Mailing address

575 Highway 51
Ridgeland, MS 39157-2593
Phone (601) 856-2383

National Provider Directory

National Provider Directory

Locations

555 Highway 51
Ridgeland, MS 39157
Phone (601) 856-2383

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460073600000",
    "number": "1649646027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 HIGHWAY 51",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572593",
            "telephone_number": "601-856-2383",
            "fax_number": "601-856-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 HIGHWAY 51",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572593",
            "telephone_number": "601-856-2383",
            "fax_number": "601-856-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2016-04-08",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "ELISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-856-2383",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.