Malissa Carnell Flagg, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC0000002248 Issued in TN

Practice address

1150 US Highway 51 Byp W
Suite a
Dyersburg, TN 38024-1888

Phone

(731) 286-8166

Fax

(731) 286-1879

NPI assigned

May 14, 2008

Last updated

Apr 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lusk Chiropractic Health Center

  • Chiropractor
  • Dyersburg, TN
  • NPI 1649549296
  NPD (past)

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1710154257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 US HIGHWAY 51 BYP W",
            "address_2": "SUITE A",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380241888",
            "telephone_number": "731-286-8166",
            "fax_number": "731-286-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 US HIGHWAY 51 BYP W",
            "address_2": "SUITE A",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380241888",
            "telephone_number": "731-286-8166",
            "fax_number": "731-286-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAGG",
        "first_name": "MALISSA",
        "middle_name": "CARNELL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000002248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sandra Jean Fowlkes, APNFNP

• Chiropractor in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.