Desutter Chiropractic Clinic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0059 Issued in MS

Legal business name

DESUTTER CHIROPRACTIC CLINIC, INC.

Practice address

9659 Goodman Rd
Olive Branch, MS 38654-1725

Phone

(662) 895-2501

Fax

(662) 895-3464

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Rachel Bumpous

Title

Chirpractor'S Asst

Phone

(662) 895-2501

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

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

• John Henry Desutter, D.C.

  • Chiropractor
  • Olive Branch, MS
  • NPI 1780791202
  Medicare reassignment NPD

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1881965283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9659 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541725",
            "telephone_number": "662-895-2501",
            "fax_number": "662-895-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9659 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541725",
            "telephone_number": "662-895-2501",
            "fax_number": "662-895-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESUTTER CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "BUMPOUS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "CHIRPRACTOR'S ASST",
        "authorized_official_telephone_number": "662-895-2501",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "0059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desoto Diagnostic Imaging, LLC
• Desoto Ear, Nose &Throat
• Desoto Family Medical Practice, P.C.
• Desoto Primary Care Clinic, PLLC
• Desoto Transportation Services LLC
• John Henry Desutter, D.C.
• Candace Fields Diamond, OTR/L
• Divine Breakthrough Ministries Worldwide (the Breakthrough Center)
• Kenyatta Lanette Dolison, RBT
• Diane Marie Donohue, M.D.

• Chiropractor in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.