NPIMap

Organization Active NPI

The Chiro Place of Douglasville PC

  • Chiropractor
  • Douglasville, GA
National Provider Identifier
1043098817
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
THE CHIRO PLACE OF DOUGLASVILLE PC
Practice address
4300 Chapel Hill Rd Ste 1200
Douglasville, GA 30135-4238
Phone
(901) 221-7173
Fax
(662) 932-8774
NPI assigned
Sep 21, 2023
Last updated
Sep 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Authorized official

Name
Dena GrangerNPI 1750653572
Title
Owner
Phone
(901) 221-7173

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

4300 Chapel Hill Rd Ste 1200
Douglasville, GA 30135-4238

Mailing address

8101 Hacks Cross Rd Ste 110
Olive Branch, MS 38654-4032
Phone (901) 221-7173

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231103003054 GA Part B Supplier - Clinic/Group Practice 8921455593 Receives reassigned benefits from 1 practitioner
Practice locations: Douglasville, GA

National Provider Directory

National Provider Directory

Locations

8101 Hacks Cross Rd
Ste 110
Olive Branch, MS 38654

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1043098817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 HACKS CROSS RD STE 110",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386544032",
            "telephone_number": "901-221-7173",
            "fax_number": "662-932-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 CHAPEL HILL RD STE 1200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301354238",
            "telephone_number": "901-221-7173",
            "fax_number": "662-932-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHIRO PLACE OF DOUGLASVILLE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "GRANGER",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-221-7173"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 Sep 21, 2023; 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.

Verify at the official NPI Registry.