Organization Active NPI

Village Chiropractic Clinic PLLC

  • Chiropractor
  • Hot Springs Village, AR
National Provider Identifier
1962740498
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15725 Issued in AR
Legal business name
VILLAGE CHIROPRACTIC CLINIC PLLC
Practice address
412 Ponce de Leon Dr
Hot Springs Village, AR 71909-8121
Phone
(214) 683-4541
NPI assigned
Jan 17, 2013
Last updated
May 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Kelli K Moore
Title
Manager
Phone
(214) 683-4541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 15725 AR Primary

Addresses

Primary practice location

412 Ponce de Leon Dr
Hot Springs Village, AR 71909-8121

Mailing address

412 Ponce de Leon Dr
Hot Springs Village, AR 71909-8121
Phone (214) 683-4541

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130513000515 AR Part B Supplier - Clinic/Group Practice 0143467001 Receives reassigned benefits from 1 practitioner
Practice locations: Hot Springs Village, AR

National Provider Directory

National Provider Directory

Locations

412 Ponce de Leon Dr
Hot Springs Village, AR 71909
Phone (214) 683-4541

412 Ponce de Leon Dr
#B
Hot Springs Village, AR 71909
Phone (214) 683-4541

Practitioners & affiliated clinicians

Practitioners 4

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": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1962740498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PONCE DE LEON DR",
            "city": "HOT SPRINGS VILLAGE",
            "state": "AR",
            "postal_code": "719098121",
            "telephone_number": "214-683-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 PONCE DE LEON DR",
            "city": "HOT SPRINGS VILLAGE",
            "state": "AR",
            "postal_code": "719098121",
            "telephone_number": "214-683-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE CHIROPRACTIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-683-4541"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "15725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs Village, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.