CENTER FOR PHYSICAL MEDICINE (NPI# 1053583674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053583674 |
| Entity Type | Organization |
| Organization Name | CENTER FOR PHYSICAL MEDICINE |
| Other Organization Name | CENTER FOR PHYSICAL MEDICINE |
| Practice Address |
1822 Huntsville Hwy Ste D Fayetteville TN 37334-3788 |
| Practice Telephone | 9314380611 |
| Practice Fax Number | 9314380622 |
| Mailing Telephone | 9314380611 |
| Mailing Fax Number | 9314380622 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2012-07-10 |
| Authorized Official Name | JAMES ERIC DEATON (OWNER) |
| Authorized Official Telephone | 9314380611 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1277 | TN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | RAILROAD MEDICARE | DD4186 | 01 |
| TN | BCBS OF TN | 3120641 | 01 |
| Other Name | Type Code |
|---|---|
| CENTER FOR PHYSICAL MEDICINE | Doing Business As Name - Organization |
| Street Address |
1822 HUNTSVILLE HWY STE D |
| City | FAYETTEVILLE |
| State | TN |
| Zip Code | 37334-3788 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902385198 | Denisia Bernadette Maldonado | Specialist/Technologist, Other | 108 Medical Center Blvd., Suite #100, Fayetteville, TN 37334 | 2018-08-09 |
| 1457801011 | Joshua Meadows | Specialist/Technologist | 101 Industrial Blvd, Fayetteville, TN 37334 | 2016-10-07 |
| 1891083762 | Kathryn Clare Moran | Physical Therapist | 1412 Huntsville Hwy, Fayetteville, TN 37334 | 2011-07-13 |
| 1891997714 | Calvin H Parks | Chiropractor | 1321 Huntsville Hwy, Fayetteville, TN 37334 | 2007-06-04 |
| 1225249691 | Stacey Starr Pace | Family Medicine | 1931 Wilson Pky, Suite A, Fayetteville, TN 37334 | 2007-05-25 |
| 1144388992 | Tom Spain Bigham IIi | Dentist | 608 West College Street, Fayetteville, TN 37334 | 2006-12-05 |
| 1932286259 | Alan B Drewry | Dentist | 602 West College Street, Fayetteville, TN 37334 | 2006-11-01 |
| 1083724561 | Samuel Michael Ashby | Internal Medicine | 804 William D Jones Blvd, Fayetteville, TN 37334 | 2006-08-30 |
| 1194336818 | Collin Amos | Pharmacist | 1000 Huntsville Hwy, Fayetteville, TN 37334 | 2020-08-14 |
| 1629450614 | William Daniel | Nurse Practitioner | 106 Medical Center Blvd, Fayetteville, TN 37334 | 2015-06-25 |
| Find all providers in zip 37334 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801421409 | Jeremy Ray Johnson | Chiropractor | 4155 N Steele Blvd Ste 10, Fayetteville, AR 72703-5377 | 2020-03-04 |
| 1811537129 | Tyler Lee Awe | Chiropractor | 3155 N College Ave Ste 103, Fayetteville, AR 72703-3500 | 2020-01-14 |
| 1982245387 | Aell Spencer Chiropractic Inc | Chiropractor | 3980 W Wedington Dr Ste 14, Fayetteville, AR 72704-5791 | 2019-10-07 |
| 1063975571 | Arkansas Biomechanics & Rehabilitation, Pllc | Chiropractor | 3801 Johnson Mill Blvd Ste A&b, Fayetteville, AR 72704-5297 | 2019-04-11 |
| 1235603200 | Arkansas Holistic Health Care Chiropractic | Chiropractor | 2618 Mlk Jr Blvd, Fayetteville, AR 72701 | 2019-01-14 |
| 1740790716 | Gabriel J Ariciu | Chiropractor | 1678 E Joyce Blvd Ste 1, Fayetteville, AR 72703-6214 | 2017-10-04 |
| 1659895605 | Parker Watkins | Chiropractor | 3761 N Mall Ave Ste 3, Fayetteville, AR 72703-4972 | 2017-08-01 |
| 1780116053 | Goodheart Chiropractic Clinic, Inc. | Chiropractor | 280 Glynn St S, Fayetteville, GA 30214-2014 | 2017-03-28 |
| 1720525041 | Eric Bell | Chiropractor | 2684 Hollybrooke Dr, Fayetteville, AR 72701-9298 | 2017-01-24 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 37334 |
Please comment or provide details below to improve the information on CENTER FOR PHYSICAL MEDICINE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.