Organization Active NPI

Poplarville Family Chiropractic

  • Chiropractor
  • Poplarville, MS
National Provider Identifier
1750454880
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1004 Issued in MS
Legal business name
POPLARVILLE FAMILY CHIROPRACTIC
Practice address
859 Highway 26 W
Poplarville, MS 39470-7467
Phone
(601) 795-0211
Fax
(601) 795-2177
NPI assigned
Nov 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kelvie D Culpepper, DCNPI 1669527503
Title
Doctor of Chiropractic
Phone
(601) 795-0211

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1287 LA
Chiropractor 111N00000X 1004 MS Primary

Addresses

Primary practice location

859 Highway 26 W
Poplarville, MS 39470-7467

Mailing address

859 Highway 26 W
Poplarville, MS 39470-7467
Phone (601) 795-0211

Other identifiers 1

IdentifierTypeStateIssuer
00124156MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060410000154 MS Part B Supplier - Clinic/Group Practice 2264441831 Receives reassigned benefits from 2 practitioners
Practice locations: Poplarville, MS

National Provider Directory

National Provider Directory

Locations

859 Highway 26 W
Poplarville, MS 39470
Phone (601) 795-0211

Practitioners & affiliated clinicians

Practitioners 5

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750454880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 HIGHWAY 26 W",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394707467",
            "telephone_number": "601-795-0211",
            "fax_number": "601-795-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 HIGHWAY 26 W",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394707467",
            "telephone_number": "601-795-0211",
            "fax_number": "601-795-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLARVILLE FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CULPEPPER",
        "authorized_official_first_name": "KELVIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "601-795-0211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1287",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124156",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplarville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.