Health Source Madison PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

HEALTH SOURCE MADISON PC

Practice address

525 Hughes Rd Ste G
Madison, AL 35758-1164

Phone

(256) 874-2643

NPI assigned

Apr 12, 2022

Last updated

Apr 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob Mathias

Title

President

Phone

(256) 874-2643

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

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.

• James Michael Richeson, DC

  • Chiropractor
  • Chattanooga, TN
  • NPI 1528616216

  AL

  Medicare reassignment NPD
• Devin Eernisse, DC

  • Chiropractor
  • Athens, AL
  • NPI 1164946281
  NPD
• Tracy Glen Bagwell, DC

  • Chiropractor
  • Huntsville, AL
  • NPI 1821028325
  NPD (past)

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1932841616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 HUGHES RD STE G",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HUGHES RD STE G",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581164",
            "telephone_number": "256-874-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SOURCE MADISON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "MATHIAS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-874-2643"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa B. Haynes, MS, CCC-A
• Rebecca Porter Haynes
• Richard Hayward
• Health Concepts Group, LLC
• Health Opera, LLC
• Healthsource of County Line Rd
• Heather Surber Licsw LLC
• Matthew Dolfi Hecker
• Katherine Ivy Heffelfinger, CRNP
• Logan Reed Heflin, CRNP

• Chiropractor in Madison, AL
• Providers in Madison, AL by specialty
• Chiropractor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.