Organization Active NPI

Patterson Chiropractic Clinic

  • Chiropractor
  • Perry, GA
National Provider Identifier
1841329034
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO02538 Issued in GA
Legal business name
PATTERSON CHIROPRACTIC CLINIC
Practice address
1304 Macon Rd
Perry, GA 31069
Phone
(478) 987-7555
Fax
(478) 988-4508
NPI assigned
Mar 5, 2007
Last updated
Jun 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Authorized official

Name
Dr. Jackson Patterson, D.C.
Title
Owner
Phone
(478) 987-7555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO02538 GA Primary

Addresses

Primary practice location

1304 Macon Rd
Perry, GA 31069

Mailing address

1304 Macon Rd
Perry, GA 31069
Phone (478) 987-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000914 GA Part B Supplier - Clinic/Group Practice 9335135839 Receives reassigned benefits from 3 practitioners
Practice locations: Perry, GA

National Provider Directory

National Provider Directory

Locations

1304 Macon Rd
Perry, GA 31069
Phone (478) 987-7555

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1841329034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 MACON RD",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "31069",
            "telephone_number": "478-987-7555",
            "fax_number": "478-988-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 MACON RD",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "31069",
            "telephone_number": "478-987-7555",
            "fax_number": "478-988-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTERSON CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-987-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO02538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.