Organization Active NPI

Eagles Landing Wellness and Chiropractic Center Inc

  • Chiropractor
  • McDonough, GA
National Provider Identifier
1659591972
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR006719 Issued in GA
Legal business name
EAGLES LANDING WELLNESS AND CHIROPRACTIC CENTER INC
Practice address
69 Old Jackson Rd
McDonough, GA 30252-3095
Phone
(678) 432-3303
Fax
(678) 432-3307
NPI assigned
Apr 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Authorized official

Name
Dr. Stephanie Rytel-Smith, D.C.
Title
Owner
Phone
(678) 432-3303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR006719 GA Primary

Addresses

Primary practice location

69 Old Jackson Rd
McDonough, GA 30252-3095

Mailing address

69 Old Jackson Rd
McDonough, GA 30252-3095
Phone (678) 432-3303

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1659591972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 OLD JACKSON RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302523095",
            "telephone_number": "678-432-3303",
            "fax_number": "678-432-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 OLD JACKSON RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302523095",
            "telephone_number": "678-432-3303",
            "fax_number": "678-432-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES LANDING WELLNESS AND CHIROPRACTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "RYTEL-SMITH",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-432-3303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.