Organization Active NPI

Spanish Fort Chiropractic LLC

  • Chiropractor
  • Spanish Fort, AL
National Provider Identifier
1992904254
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SPANISH FORT CHIROPRACTIC LLC
Practice address
8011 Spanish Fort Blvd
Spanish Fort, AL 36527-5403
Phone
(251) 625-1999
NPI assigned
Jul 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Kosette Johns
Title
Dr. Asst
Phone
(251) 625-1999

Specialties & licenses 1

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

Addresses

Primary practice location

8011 Spanish Fort Blvd
Spanish Fort, AL 36527-5403

Mailing address

8011 Spanish Fort Blvd
Spanish Fort, AL 36527-5403
Phone (251) 625-1999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060418000692 AL Part B Supplier - Clinic/Group Practice 2668481763 Receives reassigned benefits from 1 practitioner
Practice locations: Spanish Fort, AL

National Provider Directory

National Provider Directory

Locations

8011 Spanish Fort Blvd
Spanish Fort, AL 36527
Phone (251) 625-1999

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": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1992904254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8011 SPANISH FORT BLVD",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275403",
            "telephone_number": "251-625-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 SPANISH FORT BLVD",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275403",
            "telephone_number": "251-625-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPANISH FORT CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "KOSETTE",
        "authorized_official_title_or_position": "DR. ASST",
        "authorized_official_telephone_number": "251-625-1999"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fort, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.