Daniel Terry Cole, D.C.
Individual provider Active NPI Chiropractor · Waverly, TN
NPI 1861660896 · NPPES record last updated Jan 21, 2009
Key facts
- NPI
- 1861660896
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1915 (TN)
- Practice address
- 40 Walton Dr
Waverly, TN 37185-3383 - Phone
- (931) 296-7220
- NPI assigned
- Feb 12, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
103 Pavo St
Waverly, TN 37185-1527
Phone (931) 296-7220
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090506000376 | TN | Practitioner - Chiropractic | 5294883948 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1915 | TN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiropractic Brings Life | Chiropractor | Current |
Accepting new patients |
| Life Source Creating Wellness Ctr Inc | Chiropractor | Past | Accepting new patients |
Locations
103 Pavo St
Waverly, TN 37185
Phone (931) 296-7220
40 Walton Dr
Ste C
Waverly, TN 37185
Phone (931) 296-7220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1915 | TN | Yes |
Addresses
Primary practice location
40 Walton Dr
Waverly, TN 37185-3383
Mailing address
40 Walton Dr
Waverly, TN 37185-3383
Phone (931) 296-7220
Other providers in Waverly, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.