Individual provider Active NPI

Steven K Nutty, D.C.

  • Chiropractor
  • Buford, GA
National Provider Identifier
1013297217
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008877 Issued in GA
Practice address
3320 Buford Dr Ste 60
Buford, GA 30519-8703
Phone
(770) 614-1009
NPI assigned
Aug 19, 2011
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6699 CO
Chiropractor 111N00000X CHIR008877 GA Primary

Addresses

Primary practice location

3320 Buford Dr Ste 60
Buford, GA 30519-8703

Mailing address

3320 Buford Dr Ste 60
Buford, GA 30519-8703
Phone (770) 614-1009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000401 GA Practitioner - Chiropractic 6709046360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3320 Buford Dr
Suite 60
Buford, GA 30519-8703
Phone (770) 614-1009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6699COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
100 Percent Chiropractic Atlanta Two LLC Chiropractor CurrentSince Jan 27, 2012 Accepting new patients
100 Percent Chiropractic Yarbro LLC Chiropractor PastSince Feb 23, 2020 Accepting new patients
100 Chiro Nutty Hines, PC Chiropractor PastSince Oct 3, 2022 Accepting new patients

Locations

1600 Mall of Georgia Blvd
Ste 1110
Buford, GA 30519
Phone (770) 614-1009

3320 Buford Dr
Ste 60
Buford, GA 30519
Phone (770) 614-1009

Networks

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1013297217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 BUFORD DR STE 60",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305198703",
            "telephone_number": "770-614-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 BUFORD DR STE 60",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305198703",
            "telephone_number": "770-614-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTY",
        "first_name": "STEVEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6699",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.