The Chattanooga Spine and Wellness Institute, Inc

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

THE CHATTANOOGA SPINE AND WELLNESS INSTITUTE, INC

Practice address

6250 Abbotts Bridge Rd Ste 100
Duluth, GA 30097-1713

Phone

(423) 296-2604

Fax

(423) 296-2607

NPI assigned

Mar 3, 2021

Organization subpart

Yes

Parent organization

THE CHATTANOOGA SPINE AND WELLNESS INSTITUTE, INCAs reported in NPPES

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

Authorized official

Name

Jessica Noel TaylorNPI 1710204722

Title

Clinic Director

Phone

(423) 296-2604

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southeast Center for Bone and Joint Doing business as

Electronic endpoints 1

Tax ID family

Chattanooga Spine Inst Inc2 organizations share this tax ID, including this one

Part of

Chattanooga Spine Inst Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Dalton Clinic of Chiropractic Inc.

  • Chiropractor
  • Chattanooga, TN
  • NPI 1619352341
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Noel Taylor, D.C.

  • Chiropractor
  • Chattanooga, TN
  • NPI 1710204722
  NPD (past) Authorized official

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1790370633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 ABBOTTS BRIDGE RD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300971713",
            "telephone_number": "423-296-2604",
            "fax_number": "423-296-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 ABBOTTS BRIDGE RD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300971713",
            "telephone_number": "423-296-2604",
            "fax_number": "423-296-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHATTANOOGA SPINE AND WELLNESS INSTITUTE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CHATTANOOGA SPINE AND WELLNESS INSTITUTE, INC",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "NOEL",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "423-296-2604"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3957",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drtaylor@sebonecenter.com",
            "affiliation": "N",
            "address_1": "6250 Abbotts Bridge Rd Ste 100",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300971713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southeast Center for Bone and Joint",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.