Pure Chiropractic Milledgeville LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PURE CHIROPRACTIC MILLEDGEVILLE LLC

Practice address

130 Log Cabin Rd NE
Suite B
Milledgeville, GA 31061-0917

Phone

(478) 457-0003

Fax

(478) 457-0053

NPI assigned

May 22, 2012

Last updated

Jul 2, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theodore Gerald Smith, D.C.NPI 1265544340

Title

Owner

Phone

(478) 457-0003

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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.

• Theodore G. Smith, D.C.

  • Chiropractor
  • Eatonton, GA
  • NPI 1265544340
  Medicare reassignment Care Compare group NPD Authorized official
• Michael Wayne Evans Jr., DC

  • Chiropractor
  • Eatonton, GA
  • NPI 1710496138
  Medicare reassignment Care Compare group NPD
• Eric Gregory, DC

  • Chiropractor
  • Eatonton, GA
  • NPI 1215864053
  NPD

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1700146883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LOG CABIN RD NE",
            "address_2": "SUITE B",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310610917",
            "telephone_number": "478-457-0003",
            "fax_number": "478-457-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LOG CABIN RD NE",
            "address_2": "SUITE B",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310610917",
            "telephone_number": "478-457-0003",
            "fax_number": "478-457-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE CHIROPRACTIC MILLEDGEVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-457-0003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.