Active NPI
Traci Autera, DC
- Chiropractor
- Fayetteville, GA
National Provider Identifier
1053658765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 005287
- Practice address
- 1952 Highway 54 W
Fayetteville, GA 30214-4781 - Phone
- (770) 487-5211
- Fax
- (770) 487-5950
- NPI assigned
- Jan 15, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 005287 | GA | Primary |
Addresses
Primary practice location
1952 Highway 54 W
Fayetteville, GA 30214-4781
Mailing address
PO Box 2466
Peachtree City, GA 30269-0466
Phone (770) 487-5211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005287 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358208000000",
"number": "1053658765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2466",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302690466",
"telephone_number": "770-487-5211",
"fax_number": "770-487-5950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1952 HIGHWAY 54 W",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302144781",
"telephone_number": "770-487-5211",
"fax_number": "770-487-5950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUTERA",
"first_name": "TRACI",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-15",
"last_updated": "2013-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "005287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.