Organization Active NPI

Crossroads Chiropractic Center, Inc.

  • Chiropractor
  • Piney Flats, TN
National Provider Identifier
1972611259
Registry record updated Aug 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1788 Issued in TN
Legal business name
CROSSROADS CHIROPRACTIC CENTER, INC.
Practice address
5964 Highway 11 E
Piney Flats, TN 37686-4746
Phone
(423) 538-5800
Fax
(423) 538-5800
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2008

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

Authorized official

Name
Miss Jyll Michelle Pivnick, D.C
Title
Owner
Phone
(423) 538-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1788 TN Primary

Addresses

Primary practice location

5964 Highway 11 E
Piney Flats, TN 37686-4746

Mailing address

5964 Highway 11 E
Piney Flats, TN 37686-4746
Phone (423) 538-5800

Other identifiers 2

IdentifierTypeStateIssuer
3535619MedicaidTN
4012576OtherTNBCBS TN

National Provider Directory

National Provider Directory

Locations

5275 Fort Henry Dr
Kingsport, TN 37663
Phone (423) 538-5800

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217721600000",
    "number": "1972611259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5964 HIGHWAY 11 E",
            "city": "PINEY FLATS",
            "state": "TN",
            "postal_code": "376864746",
            "telephone_number": "423-538-5800",
            "fax_number": "423-538-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5964 HIGHWAY 11 E",
            "city": "PINEY FLATS",
            "state": "TN",
            "postal_code": "376864746",
            "telephone_number": "423-538-5800",
            "fax_number": "423-538-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS CHIROPRACTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2008-08-03",
        "status": "A",
        "authorized_official_last_name": "PIVNICK",
        "authorized_official_first_name": "JYLL",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-538-5800",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3535619",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4012576",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piney Flats, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.