NPIMap

Organization Active NPI

Clark Chiropractic and Wellness Care, LLC

  • Chiropractor
  • Savannah, GA
National Provider Identifier
1710476098
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009974 Issued in GA
Legal business name
CLARK CHIROPRACTIC AND WELLNESS CARE, LLC
Practice address
10725 Abercorn St Apt 143
Savannah, GA 31419-1441
Phone
(912) 996-0961
NPI assigned
May 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Kimberly Davis
Title
Credentialing Specialtsts
Phone
(912) 484-3879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR009974 GA Primary

Addresses

Primary practice location

10725 Abercorn St Apt 143
Savannah, GA 31419-1441

Mailing address

10725 Abercorn St Apt 143
Savannah, GA 31419-1441
Phone (912) 996-0961

Other identifiers 1

IdentifierTypeStateIssuer
CHIR009974OtherGACHIROPRACTIC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1710476098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10725 ABERCORN ST APT 143",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191441",
            "telephone_number": "912-996-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10725 ABERCORN ST APT 143",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191441",
            "telephone_number": "912-996-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CHIROPRACTIC AND WELLNESS CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALTSTS",
        "authorized_official_telephone_number": "912-484-3879"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC",
            "identifier": "CHIR009974",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.