Community Care Chiropractic and Rehab Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

COMMUNITY CARE CHIROPRACTIC AND REHAB CENTER, LLC

Practice address

4075 Pine Ridge Rd Ste 8
Naples, FL 34119-4004

Phone

(239) 325-9640

Fax

(239) 431-6782

NPI assigned

Oct 13, 2020

Organization subpart

No

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

Authorized official

Name

Dr. John David Goolsby, DC

Title

Owner/Chiropractor

Phone

(864) 350-5974

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602547200000",
    "number": "1891393872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 PINE RIDGE RD STE 8",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341194004",
            "telephone_number": "239-325-9640",
            "fax_number": "239-431-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 PINE RIDGE RD STE 8",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341194004",
            "telephone_number": "239-325-9640",
            "fax_number": "239-431-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE CHIROPRACTIC AND REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "GOOLSBY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "864-350-5974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.