Organization Active NPI

John Vincent DC PA

  • Chiropractor
  • Little Rock, AR
National Provider Identifier
1871745661
Registry record updated Oct 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1719 Issued in AR
Legal business name
JOHN VINCENT DC PA
Doing business as
Chenal Chiropractic
Practice address
17200 Chenal Pkwy
Suite 170
Little Rock, AR 72223-5944
Phone
(501) 821-6934
Fax
(501) 821-6915
NPI assigned
Oct 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2008

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

Authorized official

Name
Dr. John Paul Vincent, D.C.NPI 1366636169
Title
President
Phone
(501) 821-6934

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 1719 AR Primary

Addresses

Primary practice location

17200 Chenal Pkwy
Suite 170
Little Rock, AR 72223-5944

Mailing address

17200 Chenal Pkwy
Suite 170
Little Rock, AR 72223-5944
Phone (501) 821-6934

Other names 1

  • Chenal Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081029000690 AR Part B Supplier - Clinic/Group Practice 2769540152 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR

National Provider Directory

National Provider Directory

Locations

17200 Chenal Pkwy
Ste 170
Little Rock, AR 72223
Phone (315) 480-5729

13401 Chenal Pkwy
Little Rock, AR 72211
Phone (501) 517-3534

Practitioners & affiliated clinicians

Practitioners 3

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": "1223856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223856000000",
    "number": "1871745661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 CHENAL PKWY",
            "address_2": "SUITE 170",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235944",
            "telephone_number": "501-821-6934",
            "fax_number": "501-821-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 CHENAL PKWY",
            "address_2": "SUITE 170",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235944",
            "telephone_number": "501-821-6934",
            "fax_number": "501-821-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN VINCENT DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-13",
        "last_updated": "2008-10-13",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-821-6934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chenal Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; 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.