Upper Cervical Clinic of Northwest Arkansas

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

16130 Issued in AR

Legal business name

UPPER CERVICAL CLINIC OF NORTHWEST ARKANSAS

Practice address

110 Saratoga Way Ste 5
Farmington, AR 72730-2908

Phone

(479) 300-6031

NPI assigned

Dec 1, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jackson Chism, DC

Title

Owner

Phone

(479) 300-6031

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1760997506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SARATOGA WAY STE 5",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727302908",
            "telephone_number": "479-300-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SARATOGA WAY STE 5",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727302908",
            "telephone_number": "479-300-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER CERVICAL CLINIC OF NORTHWEST ARKANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "CHISM",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-300-6031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Farmington, AR
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.