NPIMap

Organization Active NPI

Healthsource of Jackson

  • Chiropractor
  • Jackson, TN
National Provider Identifier
1811286651
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1931 Issued in TN
Legal business name
HEALTHSOURCE OF JACKSON
Practice address
384 Carriage House Dr Ste C
Jackson, TN 38305-2268
Phone
(731) 661-0390
Fax
(731) 664-6697
NPI assigned
Apr 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Authorized official

Name
Dr. Gina Ann Heathcott, D.C.NPI 1548311384
Title
Owner
Phone
(731) 661-0390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1931 TN Primary

Addresses

Primary practice location

384 Carriage House Dr Ste C
Jackson, TN 38305-2268

Mailing address

384 Carriage House Dr Ste C
Jackson, TN 38305-2268
Phone (731) 661-0390

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1811286651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 CARRIAGE HOUSE DR STE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052268",
            "telephone_number": "731-661-0390",
            "fax_number": "731-664-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 CARRIAGE HOUSE DR STE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052268",
            "telephone_number": "731-661-0390",
            "fax_number": "731-664-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "HEATHCOTT",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-661-0390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.