Organization Active NPI

Heartland Clinic of Chiropractic

  • Chiropractor
  • Monticello, GA
National Provider Identifier
1659714640
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009087 Issued in GA
Legal business name
HEARTLAND CLINIC OF CHIROPRACTIC
Practice address
111 W Washington St
Monticello, GA 31064-1239
Phone
(706) 468-6500
NPI assigned
Apr 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Authorized official

Name
Dr. Lyndsy A Holman, D.C.
Title
Manager
Phone
(706) 468-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR009087 GA Primary

Addresses

Primary practice location

111 W Washington St
Monticello, GA 31064-1239

Mailing address

111 W Washington St
P.O. Box 166
Monticello, GA 31064-1239
Phone (706) 468-6500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130430000650 GA Part B Supplier - Clinic/Group Practice 7618114141 Receives reassigned benefits from 1 practitioner
Practice locations: Monticello, GA

National Provider Directory

National Provider Directory

Locations

972 College St
Monticello, GA 31064
Phone (706) 468-6500

111 W Washington St
Monticello, GA 31064
Phone (706) 468-6500

Practitioners & affiliated clinicians

Practitioners 3

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": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1659714640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W WASHINGTON ST",
            "address_2": "P.O. BOX 166",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "310641239",
            "telephone_number": "706-468-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W WASHINGTON ST",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "310641239",
            "telephone_number": "706-468-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND CLINIC OF CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "LYNDSY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "706-468-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.