Organization Active NPI

Beth Anne Flack DC PC

Doing business as Flack Family Chiropractic

  • Chiropractor
  • Evans, GA
National Provider Identifier
1932479052
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008359 Issued in GA
Legal business name
BETH ANNE FLACK DC PC
Doing business as
Flack Family Chiropractic
Practice address
4246 Washington Rd Ste 6
Evans, GA 30809-3345
Phone
(706) 305-3241
Fax
(706) 733-6018
NPI assigned
Jan 5, 2012
Last updated
Sep 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Authorized official

Name
Dr. Beth Anne Flack, D.C.NPI 1568637585
Title
Owner
Phone
(706) 305-3241

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 CHIR008359 GA Primary

Addresses

Primary practice location

4246 Washington Rd Ste 6
Evans, GA 30809-3345

Mailing address

4246 Washington Rd Ste 6
Evans, GA 30809-3345
Phone (706) 305-3241

Other names 1

  • Flack Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121121000427 GA Part B Supplier - Clinic/Group Practice 5991956948 Receives reassigned benefits from 1 practitioner
Practice locations: Evans, GA

National Provider Directory

National Provider Directory
Tax ID family
Beth Anne Flack DC PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4246 Washington Rd
Ste 6
Evans, GA 30809
Phone (706) 305-3241

4488 Columbia Rd
Martinez, GA 30907
Phone (706) 305-3241

Practitioners & affiliated clinicians

Practitioners 1

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": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1932479052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4246 WASHINGTON RD STE 6",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093345",
            "telephone_number": "706-305-3241",
            "fax_number": "706-922-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4246 WASHINGTON RD STE 6",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093345",
            "telephone_number": "706-305-3241",
            "fax_number": "706-733-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH ANNE FLACK DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "FLACK",
        "authorized_official_first_name": "BETH ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-305-3241",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flack Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Flack Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.