Active NPI
Evans Paul Peters, D.C
- Chiropractor
- Douglasville, GA
National Provider Identifier
1013949205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- GA2168
- Practice address
- 3379 Highway 5
Suite I
Douglasville, GA 30135-6928 - Phone
- (770) 942-1883
- Fax
- (770) 942-3764
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | GA2168 | GA | Primary |
Addresses
Primary practice location
3379 Highway 5
Suite I
Douglasville, GA 30135-6928
Mailing address
3379 Highway 5
Suite I
Douglasville, GA 30135-6928
Phone (770) 942-1883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120125000674 | GA | Practitioner - Chiropractic | 5991972341 | Practice locations: Douglasville, GA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2168 | GA | MD | Clinical Psychologist |
| GA2168 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1013949205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3379 HIGHWAY 5",
"address_2": "SUITE I",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301356928",
"telephone_number": "770-942-1883",
"fax_number": "770-942-3764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3379 HIGHWAY 5",
"address_2": "SUITE I",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301356928",
"telephone_number": "770-942-1883",
"fax_number": "770-942-3764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "EVANS",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "GA2168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.