David Dow Black III, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR002164 Issued in GA

Practice address

799 Main Street North
Cornelia, GA 30531

Phone

(706) 778-4013

Fax

(706) 778-9549

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1983

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Networks

• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• FL HMO
• FL HMO D-SNP
• TN PPO C-SNP
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• TN PPO
• FL HMO C-SNP
• AL HMO
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• AL HMO D-SNP
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013015015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 MAIN STREET NORTH",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "305312353",
            "telephone_number": "706-778-4013",
            "fax_number": "706-778-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 MAIN STREET NORTH",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "30531",
            "telephone_number": "706-778-4013",
            "fax_number": "706-778-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DAVID",
        "middle_name": "DOW",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR002164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Abercrombie
• Heather Lorin Adams, PT, DPT
• Chester Riley Baker, NP RN CS
• Ashley Bardash, OTR/L
• Bryan Bardash, CRNA
• Hayden Black, PHARMD
• Andrew J Brent, LPC
• Debra Marie Cain, ED.S.
• Kelly Beth Cain, PHARMD
• Donald Cantrell Jr., D.M.D.

• All providers in Cornelia, GA
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.