NPIMap

Organization Active NPI

George Chiropractic Clinic Inc.

  • Health Service Clinic/Center
  • Wynne, AR
National Provider Identifier
1699856872
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
1452 Issued in AR
Legal business name
GEORGE CHIROPRACTIC CLINIC INC.
Practice address
1718 N Falls Blvd
Wynne, AR 72396-0498
Phone
(870) 238-8707
Fax
(870) 238-8711
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kenneth Dewayne George, D.C.
Title
Doctor Owner
Phone
(870) 238-8707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 1452 AR Primary

Addresses

Primary practice location

1718 N Falls Blvd
Wynne, AR 72396-0498

Mailing address

PO Box 498
1718 N Falls Blvd
Wynne, AR 72396-0498
Phone (870) 238-8707

Other identifiers 1

IdentifierTypeStateIssuer
5T670OtherARBLUE CROSS AND BLUE SHIEL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699856872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 498",
            "address_2": "1718 N FALLS BLVD",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723960498",
            "telephone_number": "870-238-8707",
            "fax_number": "870-238-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 N FALLS BLVD",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723960498",
            "telephone_number": "870-238-8707",
            "fax_number": "870-238-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE CHIROPRACTIC CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "DEWAYNE",
        "authorized_official_title_or_position": "DOCTOR OWNER",
        "authorized_official_telephone_number": "870-238-8707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AR",
            "license": "1452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "5T670",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.