Organization Active NPI

Smith Family Chiropractic PLLC

  • Chiropractor
  • Kiln, MS
National Provider Identifier
1730254343
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1085 Issued in MS
Legal business name
SMITH FAMILY CHIROPRACTIC PLLC
Practice address
16195 Highway 603
Kiln, MS 39556-8269
Phone
(228) 586-9343
Fax
(228) 586-9341
NPI assigned
Nov 21, 2006
Last updated
Sep 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Authorized official

Name
Dr. Brandon Reed Smith, D.C.NPI 1417022708
Title
Member-Owner
Phone
(228) 586-9343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1085 MS Primary

Addresses

Primary practice location

16195 Highway 603
Kiln, MS 39556-8269

Mailing address

PO Box 1447
Kiln, MS 39556-1447
Phone (228) 586-9343

Other identifiers 2

IdentifierTypeStateIssuer
05088327MedicaidMS
08432735MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140310000347 MS Part B Supplier - Clinic/Group Practice 8123258308 Receives reassigned benefits from 1 practitioner
Practice locations: Kiln, MS

National Provider Directory

National Provider Directory

Locations

16195 Highway 603
Kiln, MS 39556
Phone (228) 586-9343

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1730254343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "KILN",
            "state": "MS",
            "postal_code": "395561447",
            "telephone_number": "228-586-9343",
            "fax_number": "228-586-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16195 HIGHWAY 603",
            "city": "KILN",
            "state": "MS",
            "postal_code": "395568269",
            "telephone_number": "228-586-9343",
            "fax_number": "228-586-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH FAMILY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "MEMBER-OWNER",
        "authorized_official_telephone_number": "228-586-9343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05088327",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08432735",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kiln, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.