Individual provider Active NPI

Ladarian Shawntell Gregory, D.C.

  • Chiropractor
  • Decatur, GA
National Provider Identifier
1003093543
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007452 Issued in GA
Practice address
2853 Candler Rd Ste 5
Decatur, GA 30034-1421
Phone
(678) 612-7137
Fax
(404) 212-7694
NPI assigned
Jan 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007452 GA Primary

Addresses

Primary practice location

2853 Candler Rd Ste 5
Decatur, GA 30034-1421

Mailing address

2853 Candler Rd Ste 5
Decatur, GA 30034-1421
Phone (678) 612-7137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1003093543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2853 CANDLER RD STE 5",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300341421",
            "telephone_number": "678-612-7137",
            "fax_number": "404-212-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2853 CANDLER RD STE 5",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300341421",
            "telephone_number": "678-612-7137",
            "fax_number": "404-212-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "LADARIAN",
        "middle_name": "SHAWNTELL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "007452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.