Table Rock Chiropractic P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2009019491 Issued in MO

Legal business name

TABLE ROCK CHIROPRACTIC P.C.

Practice address

2 Kissee Ave
Suite E
Kimberling City, MO 65686-9701

Phone

(417) 739-9000

Fax

(417) 739-9002

NPI assigned

May 16, 2011

Last updated

Sep 23, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adam Smith, DCNPI 1588894828

Title

Owner

Phone

(417) 399-6893

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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.

• Adam J Smith, D. C.

  • Chiropractor
  • Kimberling City, MO
  • NPI 1588894828
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316736000000",
    "number": "1801189444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 KISSEE AVE",
            "address_2": "SUITE E",
            "city": "KIMBERLING CITY",
            "state": "MO",
            "postal_code": "656869701",
            "telephone_number": "417-739-9000",
            "fax_number": "417-739-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 KISSEE AVE",
            "address_2": "SUITE E",
            "city": "KIMBERLING CITY",
            "state": "MO",
            "postal_code": "656869701",
            "telephone_number": "417-739-9000",
            "fax_number": "417-739-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABLE ROCK CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-09-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-399-6893",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2009019491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renae Jenelle Richardson
• Skaggs Community Hospital Association (CoxHealth Center Kimberling City)
• Adam J Smith, D. C.
• Lydia Ann Snavely, M.S., CFY-SLP
• Andrea Sosa
• Table Rock Counseling, LLC
• Stephanie Ann Thierbach, OTR/L
• Benton Drew Tolleson, LMSW
• Mellisa J Tucker, PTA
• Anne Elizabeth Wilson Coleman, LPC

• Chiropractor in Kimberling City, MO
• Providers in Kimberling City, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.