Active NPI
Kent D. Vanderslice, DC
- Chiropractor
- Dallas, GA
National Provider Identifier
1710008412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR006287
- Practice address
- 110 Evans Mill Dr
Suie 304
Dallas, GA 30157-1622 - Phone
- (770) 505-5655
- Fax
- (770) 505-5654
- NPI assigned
- Apr 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR006287 | GA | Primary |
Addresses
Primary practice location
110 Evans Mill Dr
Suie 304
Dallas, GA 30157-1622
Mailing address
110 Evans Mill Dr
Suite 304
Dallas, GA 30157-1622
Phone (770) 505-5655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR006287 | GA | MD | Chiropractor |
Interoperability endpoints
- kent.vanderslice.p1@direct.life.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227139200000",
"number": "1710008412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 EVANS MILL DR",
"address_2": "SUITE 304",
"city": "DALLAS",
"state": "GA",
"postal_code": "301571622",
"telephone_number": "770-505-5655",
"fax_number": "770-505-5654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 EVANS MILL DR",
"address_2": "SUIE 304",
"city": "DALLAS",
"state": "GA",
"postal_code": "301571622",
"telephone_number": "770-505-5655",
"fax_number": "770-505-5654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERSLICE",
"first_name": "KENT",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2008-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR006287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.