Organization Active NPI

Haven Chiropractic PLLC

  • Chiropractor
  • Jonesboro, AR
National Provider Identifier
1952046898
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HAVEN CHIROPRACTIC PLLC
Practice address
4119 Stadium Blvd Ste H
Jonesboro, AR 72404-9465
Phone
(870) 277-2541
NPI assigned
May 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Authorized official

Name
Danielle Craig, DC
Title
Owner
Phone
(870) 277-2541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4119 Stadium Blvd Ste H
Jonesboro, AR 72404-9465

Mailing address

4119 Stadium Blvd Ste H
Jonesboro, AR 72404-9465

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220706000067 AR Part B Supplier - Clinic/Group Practice 6709266968 Receives reassigned benefits from 1 practitioner
Practice locations: Jonesboro, AR

National Provider Directory

National Provider Directory

Locations

4119 Stadium Blvd
Ste H
Jonesboro, AR 72404
Phone (870) 277-2541

Practitioners & affiliated clinicians

Practitioners 1

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": "1651622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651622400000",
    "number": "1952046898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 STADIUM BLVD STE H",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 STADIUM BLVD STE H",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049465",
            "telephone_number": "870-277-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-04",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-277-2541",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.