Organization Active NPI

Pine Belt Chiropractic Inc

  • Chiropractor
  • Hattiesburg, MS
National Provider Identifier
1841517430
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
985 Issued in MS
Legal business name
PINE BELT CHIROPRACTIC INC
Practice address
117 Thornhill Dr
Hattiesburg, MS 39402-1548
Phone
(601) 268-8805
Fax
(601) 268-8875
NPI assigned
Apr 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Authorized official

Name
Dr. Greg H. Hairston, D.C.NPI 1750435301
Title
Doctor of Chiropractic
Phone
(601) 268-8805

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 985 MS Primary

Addresses

Primary practice location

117 Thornhill Dr
Hattiesburg, MS 39402-1548

Mailing address

117 Thornhill Dr
Hattiesburg, MS 39402-1548
Phone (601) 268-8805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101221000721 MS Part B Supplier - Clinic/Group Practice 3678761400 Receives reassigned benefits from 1 practitioner
Practice locations: Hattiesburg, MS

National Provider Directory

National Provider Directory

Locations

117 Thornhill Dr
Hattiesburg, MS 39402
Phone (601) 268-8805

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": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1841517430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 THORNHILL DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021548",
            "telephone_number": "601-268-8805",
            "fax_number": "601-268-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 THORNHILL DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021548",
            "telephone_number": "601-268-8805",
            "fax_number": "601-268-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE BELT CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "HAIRSTON",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "601-268-8805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

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