John Henry Desutter, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0059 Issued in MS

Practice address

9659 E. Goodman Ave
Olive Branch, MS 38654

Phone

(662) 895-2501

Fax

(662) 895-3464

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Desutter Chiropractic Clinic, Inc.

  • Chiropractor
  • Olive Branch, MS
  • NPI 1881965283
  Medicare reassignment NPD

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780791202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9659 E. GOODMAN AVE",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "662-895-2501",
            "fax_number": "662-895-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9659 E. GOODMAN AVE",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "662-895-2501",
            "fax_number": "662-895-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESUTTER",
        "first_name": "JOHN",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "0059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desoto Ear, Nose &Throat
• Desoto Family Medical Practice, P.C.
• Desoto Primary Care Clinic, PLLC
• Desoto Transportation Services LLC
• Desutter Chiropractic Clinic, Inc.
• Candace Fields Diamond, OTR/L
• Divine Breakthrough Ministries Worldwide (the Breakthrough Center)
• Kenyatta Lanette Dolison, RBT
• Diane Marie Donohue, M.D.
• Stephanie Machelle Douglass, PMHNP-BC

• Chiropractor in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.