Organization Active NPI

Lookout Valley Chiropractic

  • Sports Physician Chiropractor
  • Chattanooga, TN
National Provider Identifier
1770663239
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
1430 Issued in TN
Legal business name
LOOKOUT VALLEY CHIROPRACTIC
Practice address
3536 Cummings Hwy
Ste120
Chattanooga, TN 37419-2435
Phone
(423) 825-5252
Fax
(423) 825-1228
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Mr. Neil J Kjos, D.C.
Title
Chiropractor
Phone
(423) 825-5252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 1430 TN Primary

Addresses

Primary practice location

3536 Cummings Hwy
Ste120
Chattanooga, TN 37419-2435

Mailing address

3536 Cummings Hwy
Ste120
Chattanooga, TN 37419-2435
Phone (423) 825-5252

Other identifiers 4

IdentifierTypeStateIssuer
350052346OtherGARAILROAD MC PALMETTO GBA
5011638OtherTNAETNA PIN
000933226AMedicaidGA
3069538OtherTNBLUE CROSS PIN

National Provider Directory

National Provider Directory

Locations

1724 Ooltewah Ringgold Rd
Ooltewah, TN 37363
Phone (423) 531-2838

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1770663239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 CUMMINGS HWY",
            "address_2": "STE120",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374192435",
            "telephone_number": "423-825-5252",
            "fax_number": "423-825-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 CUMMINGS HWY",
            "address_2": "STE120",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374192435",
            "telephone_number": "423-825-5252",
            "fax_number": "423-825-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOOKOUT VALLEY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "KJOS",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "423-825-5252",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "TN",
            "license": "1430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC PALMETTO GBA",
            "identifier": "350052346",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "5011638",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000933226A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "3069538",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.