Organization Active NPI

Perfect Chiropractic

  • Chiropractor
  • Collierville, TN
National Provider Identifier
1922469485
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 2842 Issued in TN
Legal business name
PERFECT CHIROPRACTIC
Practice address
1011 W Poplar Ave
Suite 1
Collierville, TN 38017-2585
Phone
(901) 602-9295
NPI assigned
Mar 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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

Authorized official

Name
Alan Richard Fredericks, DCNPI 1386005163
Title
Owner
Phone
(901) 602-9295

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 DC 2842 TN Primary

Addresses

Primary practice location

1011 W Poplar Ave
Suite 1
Collierville, TN 38017-2585

Mailing address

1011 W Poplar Ave
Suite 1
Collierville, TN 38017-2585
Phone (901) 602-9295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170406000534 TN Part B Supplier - Clinic/Group Practice 5294011326 Receives reassigned benefits from 1 practitioner
Practice locations: Collierville, TN

National Provider Directory

National Provider Directory

Locations

1011 W Poplar Ave
Ste 1
Collierville, TN 38017
Phone (901) 316-8762

Practitioners & affiliated clinicians

Practitioners 2

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": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1922469485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W POPLAR AVE",
            "address_2": "SUITE 1",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172585",
            "telephone_number": "901-602-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W POPLAR AVE",
            "address_2": "SUITE 1",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172585",
            "telephone_number": "901-602-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "FREDERICKS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-602-9295",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC 2842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.