NPIMap

Organization Active NPI

Perry Chiropractic of Warner Robins, LLC

  • Chiropractor
  • Warner Robins, GA
National Provider Identifier
1053966150
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PERRY CHIROPRACTIC OF WARNER ROBINS, LLC
Practice address
4027 Watson Blvd Ste 180
Warner Robins, GA 31093-9544
Phone
(478) 987-9666
NPI assigned
Aug 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Authorized official

Name
Brian Gillis, DC
Title
Owner
Phone
(478) 987-9666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4027 Watson Blvd Ste 180
Warner Robins, GA 31093-9544

Mailing address

PO Box 628
Perry, GA 31069-0628
Phone (478) 987-9666

Other names 1

  • Perry Chiropractic of Warner Robins Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191120000466 GA Part B Supplier - Clinic/Group Practice 7719319375 Receives reassigned benefits from 6 practitioners
Practice locations: Warner Robins, GA

National Provider Directory

National Provider Directory

Locations

1207 Main St
Ste C
Perry, GA 31069
Phone (478) 987-9666

4027 Watson Blvd
Ste 180
Warner Robins, GA 31093
Phone (478) 333-1773

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565049600000",
    "number": "1053966150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310690628",
            "telephone_number": "478-987-9666",
            "fax_number": "478-988-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 WATSON BLVD STE 180",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310939544",
            "telephone_number": "478-987-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY CHIROPRACTIC OF WARNER ROBINS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A",
        "authorized_official_last_name": "GILLIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-987-9666",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry Chiropractic of Warner Robins",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.