Organization Active NPI

Mid South Chiropractic PLLC

  • Chiropractor
  • Olive Branch, MS
National Provider Identifier
1912380528
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MID SOUTH CHIROPRACTIC PLLC
Practice address
6942 Autumn Oaks Dr
A
Olive Branch, MS 38654-9379
Phone
(662) 890-0012
NPI assigned
Jun 30, 2015
Last updated
Feb 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Authorized official

Name
Brittany A Kasprack, DCNPI 1528448685
Title
Owner/Manager
Phone
(901) 371-1523

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

6942 Autumn Oaks Dr
A
Olive Branch, MS 38654-9379

Mailing address

6942 Autumn Oaks Dr
A
Olive Branch, MS 38654-9379

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160323002255 MS Part B Supplier - Clinic/Group Practice 0143527846 Receives reassigned benefits from 3 practitioners
Practice locations: Olive Branch, MS

National Provider Directory

National Provider Directory

Locations

6942 Autumn Oaks Dr
Ste A
Olive Branch, MS 38654
Phone (662) 890-0012

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1912380528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6942 AUTUMN OAKS DR",
            "address_2": "A",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386549379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6942 AUTUMN OAKS DR",
            "address_2": "A",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386549379",
            "telephone_number": "662-890-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "KASPRACK",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "901-371-1523",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.