Suttles Family Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SUTTLES FAMILY CHIROPRACTIC, LLC

Practice address

1441 Hartwell Hwy
Elberton, GA 30635-3405

Phone

(706) 340-7671

NPI assigned

Jun 21, 2022

Last updated

Dec 30, 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

Dr. Carissa Janine Suttles, DCNPI 1245266865

Title

Owner

Phone

(706) 340-7671

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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.

• Carissa Janine Suttles, D.C.

  • Chiropractor
  • Elberton, GA
  • NPI 1245266865
  Medicare reassignment NPD Authorized official
• Meredith Marchelle Harrison-Spears, D.C.

  • Chiropractor
  • Athens, GA
  • NPI 1750317236
  NPD (past)
• Lisa Alejandra Wilbur, LMT

  • Massage Therapist
  • Athens, GA
  • NPI 1285906222
  NPD (past)

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1942931845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 EDWARDS DR",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306354404",
            "telephone_number": "706-340-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 HARTWELL HWY",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306353405",
            "telephone_number": "706-340-7671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "485 Huntington Rd Ste 194",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306061845",
            "country_code": "US",
            "telephone_number": "706-340-7671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUTTLES FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "SUTTLES",
        "authorized_official_first_name": "CARISSA",
        "authorized_official_middle_name": "JANINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-340-7671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11614811",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CHIR007885",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PLAN NETWORK ID",
            "identifier": "P01084237",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Elberton, GA
• Providers in Elberton, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.