SOUTHEAST SPINE & SPORTS MEDICINE (NPI# 1821482589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821482589 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST SPINE & SPORTS MEDICINE |
| Practice Address |
1399 No Pone Valley Rd Georgetown TN 37336-4846 |
| Practice Telephone | 3863662153 |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-09-18 |
| Authorized Official Name | DR. TREVOR THOMPSON SHAW (OWNER / DOCTOR) |
| Authorized Official Telephone | 3863662153 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2778 | TN | Chiropractic Providers |
| Street Address |
1399 NO PONE VALLEY RD |
| City | GEORGETOWN |
| State | TN |
| Zip Code | 37336-4846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467772954 | Trevor Thompson Shaw | Chiropractor | 1399 No Pone Valley Rd, Georgetown, TN 37336-4846 | 2010-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497276323 | Open Arms Care Corporation | Intermediate Care Facility, Mentally Retarded | 7815 Gamble Road, Georgetown, TN 37336 | 2017-06-30 |
| 1851812796 | Open Arms Care Corporation | Intermediate Care Facility, Mentally Retarded | 7817 Gamble Road, Georgetown, TN 37336 | 2017-06-30 |
| 1245455716 | Ginger Cobble | Specialist/Technologist, Other | 410 Riverview Estates Lane, Georgetown, TN 37336 | 2007-04-17 |
| 1225171796 | Open Arms Care Corporation | Intermediate Care Facility, Mentally Retarded | 11421 Highway 58, Georgetown, TN 37336-4040 | 2007-02-15 |
| 1952444614 | Open Arms Care Corporation | Intermediate Care Facility, Mentally Retarded | 11419 Highway 58, Georgetown, TN 37336-4040 | 2007-02-14 |
| 1306211404 | Erik Zeliski | Nurse Anesthetist, Certified Registered | 7007 B and K Ranch Rd, Georgetown, TN 37336-4588 | 2015-12-01 |
| 1376890095 | Gabriel Meghan Hopkins | Counselor | 284 Dean Dr Nw, Georgetown, TN 37336-5000 | 2012-08-13 |
| 1487163903 | Savanah Kincaid | Registered Nurse | 236 Sue Cir Nw, Georgetown, TN 37336-5013 | 2017-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952901753 | Hq Dental Design | Clinic/Center | 3011 Dawn Dr Ste 105, Georgetown, TX 78628-2827 | 2020-10-29 |
| 1396345377 | Doris Donaway | Psychologist | 17 Merganser Rd Lot 95, Georgetown, DE 19947-9552 | 2020-10-28 |
| 1528668803 | Gwendolyn Marie Dicapo | Counselor | 207 S Elm St, Georgetown, TX 78626-5042 | 2020-10-27 |
| 1447850789 | Caitlin Brooke Callihan | Pharmacist | 1001 Cherry Blossom Way # Way7, Georgetown, KY 40324-9564 | 2020-10-27 |
| 1467051953 | Deontay Adrain Winchester | Counselor | 500 S Kaminski St Ste 213, Georgetown, SC 29440-3435 | 2020-10-26 |
| 1932709482 | Alexxis Nicole Warford | Counselor | 505 W University Ave Ste 105, Georgetown, TX 78626-6643 | 2020-10-26 |
| 1063011922 | Eden Alcoseba | Spec/Tech, Pathology | 2300 Wolf Ranch Pkwy Apt 6201, Georgetown, TX 78628-7299 | 2020-10-21 |
| 1124627286 | Kirsten Rene Parker | Chiropractor | 750 County Road 234 Bldg 1, Georgetown, TX 78633-4426 | 2020-10-20 |
| 1124626700 | Mind & Body Wellness | Nurse Practitioner | 105 Bob White Path, Georgetown, KY 40324-6169 | 2020-10-15 |
| 1740888742 | Bryan Hutchison | Counselor | 141 Mountain Valley St, Georgetown, TX 78628-2199 | 2020-10-12 |
| Find all providers in GEORGETOWN | ||||
| 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 |
|---|---|---|---|---|
| 1124627286 | Kirsten Rene Parker | Chiropractor | 750 County Road 234 Bldg 1, Georgetown, TX 78633-4426 | 2020-10-20 |
| 1053973644 | Georgetown Chiropractic Center | Chiropractor | 1304 Paris Pike, Georgetown, KY 40324-9704 | 2019-07-03 |
| 1376001651 | Shelby Danielle Phillips | Chiropractor | 1520 Leander Rd Ste 103, Georgetown, TX 78628-8842 | 2019-03-06 |
| 1366918252 | Sammie Mees | Chiropractor | 1103 Williams Dr Ste 101, Georgetown, TX 78628-4109 | 2018-10-17 |
| 1043706344 | Acc-georgetown LLC | Chiropractor | 3007 Dawn Dr Ste 101, Georgetown, TX 78628-2864 | 2018-07-10 |
| 1124526223 | Legacy Chiropractic Inc | Chiropractor | 205 Champion Way Ste 9, Georgetown, KY 40324-8862 | 2018-01-24 |
| 1255845830 | Chelsea Hartinger | Chiropractor | 105 Windsor Path Ste 4, Georgetown, KY 40324-9819 | 2017-11-19 |
| 1457877342 | Credence Chiropractic LLC | Chiropractor | 1103 Rivery Dr Ste 120, Georgetown, TX 78628-3056 | 2017-08-22 |
| 1134519127 | Miranda Wall | Chiropractor | 100 River Hills Dr Ste 102, Georgetown, TX 78628-3682 | 2015-01-28 |
| 1043617202 | Waccamaw Family Chiropractic, P.C. | Chiropractor | 1153 N Fraser St, Georgetown, SC 29440-2851 | 2014-12-03 |
| Find all providers in GEORGETOWN | ||||
| City | GEORGETOWN |
| Zip Code | 37336 |
Please comment or provide details below to improve the information on SOUTHEAST SPINE & SPORTS 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.