Individual provider Active NPI

Jarrod Wise, D.C.

  • Chiropractor
  • Alpharetta, GA
National Provider Identifier
1053859827
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR07337 Issued in GA
Practice address
11525 Haynes Bridge Rd
Suite 120
Alpharetta, GA 30009-4821
Phone
(770) 772-3500
NPI assigned
Feb 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR07337 GA Primary

Addresses

Primary practice location

11525 Haynes Bridge Rd
Suite 120
Alpharetta, GA 30009-4821

Mailing address

3774 Ashford Lake CT NE
Brookhaven, GA 30319-1861
Phone (404) 944-1813

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CHIR07337GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Family Healthcare Chiropractor PastSince Jul 18, 2009 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21705/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1053859827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3774 ASHFORD LAKE CT NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303191861",
            "telephone_number": "404-944-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 HAYNES BRIDGE RD",
            "address_2": "SUITE 120",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300094821",
            "telephone_number": "770-772-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JARROD",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR07337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.