Individual provider Active NPI

Christopher R Huckle, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Braselton, GA
National Provider Identifier
1023400777
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
78480 Issued in GA
Practice address
1404 River PL Ste 401
Braselton, GA 30517
Phone
(770) 848-6190
NPI assigned
Mar 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 78480 GA Primary

Addresses

Primary practice location

1404 River PL Ste 401
Braselton, GA 30517

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

233 N Houston Rd Ste 140E
Warner Robins, GA 31093-3023
Phone (478) 975-6880

Other practice location 2

233 N Houston Rd Ste 140E
Warner Robins, GA 31093-3023
Phone (478) 975-6880

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chuckle100931@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190719001479 GA Practitioner - Sports MedicinePractitioner - Family Practice 3678862935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
William Carey University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

1404 River PL
Suite 401
Braselton, GA 30517-5600
Phone (770) 848-6190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
78480GAMDSports Medicine (Family Medicine) Physician
7920GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Sports Medicine CurrentSince Aug 1, 2019 Accepting new patients

Locations

1404 River Pl
Ste 401
Braselton, GA 30517

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1023400777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 RIVER PL STE 401",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "30517",
            "telephone_number": "770-848-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "233 N Houston Rd Ste 140E",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310933023",
            "country_code": "US",
            "telephone_number": "478-975-6880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "233 N Houston Rd Ste 140E",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310933023",
            "country_code": "US",
            "telephone_number": "478-975-6880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUCKLE",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-03",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "78480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chuckle100931@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1404 River Pl Ste 401",
            "city": "Braselton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Braselton, GA

Sources for this page

Verify at the official NPI Registry.