Individual provider Active NPI

Yoshiro Yajima, D.C.

  • Nutrition Chiropractor
  • Doraville, GA
National Provider Identifier
1033340351
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CHIR008506 Issued in GA
Practice address
5000 Winters Chapel Rd Ste 1
Doraville, GA 30360-1746
Phone
(678) 855-6611
NPI assigned
Aug 4, 2009
Last updated
Apr 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X CHIR008506 GA Primary

Addresses

Primary practice location

5000 Winters Chapel Rd Ste 1
Doraville, GA 30360-1746

Mailing address

5000 Winters Chapel Rd Ste 1
Doraville, GA 30360-1746
Phone (678) 855-6611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100203000294 GA Practitioner - Chiropractic 9335282011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5000 Winters Chapel Rd
Suite 1
Doraville, GA 30360-1746
Phone (770) 557-0706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008506GAMDNutrition Chiropractor

Organizations & group practices 1

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": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1033340351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 WINTERS CHAPEL RD STE 1",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303601746",
            "telephone_number": "678-855-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 WINTERS CHAPEL RD STE 1",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303601746",
            "telephone_number": "678-855-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAJIMA",
        "first_name": "YOSHIRO",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "GA",
            "license": "CHIR008506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doraville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.