NPIMap

Organization Active NPI

Cleburne Chiropractic Center

  • Chiropractor
  • Heflin, AL
National Provider Identifier
1699764035
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1330 Issued in AL
Legal business name
CLEBURNE CHIROPRACTIC CENTER
Practice address
959 Ross St
Heflin, AL 36264-1165
Phone
(256) 463-5555
Fax
(256) 463-5537
NPI assigned
Oct 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Authorized official

Name
Dr. Mark J Hammock, DCNPI 1174712400
Title
President Chiropractor
Phone
(256) 463-5555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1330 AL Primary

Addresses

Primary practice location

959 Ross St
Heflin, AL 36264-1165

Mailing address

959 Ross St
PO Box 215
Heflin, AL 36264-1165
Phone (256) 463-5555

Other names 1

  • Cleburne Chriopractic Center PC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060111000693 AL Part B Supplier - Clinic/Group Practice 9436172871 Receives reassigned benefits from 1 practitioner
Practice locations: Heflin, AL

National Provider Directory

National Provider Directory

Locations

959 Ross St
Heflin, AL 36264
Phone (256) 463-5555

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": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1699764035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 ROSS ST",
            "address_2": "PO BOX 215",
            "city": "HEFLIN",
            "state": "AL",
            "postal_code": "362641165",
            "telephone_number": "256-463-5555",
            "fax_number": "256-463-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 ROSS ST",
            "city": "HEFLIN",
            "state": "AL",
            "postal_code": "362641165",
            "telephone_number": "256-463-5555",
            "fax_number": "256-463-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEBURNE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "HAMMOCK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT CHIROPRACTOR",
        "authorized_official_telephone_number": "256-463-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleburne Chriopractic Center PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Heflin, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.