Guwoin Ingram Jr Jr.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR011110 Issued in GA

Practice address

2210 Holly Springs Pkwy Ste 100
Canton, GA 30115-9013

Phone

(770) 562-5446

NPI assigned

Nov 2, 2024

Last updated

Nov 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dotson Stevens Enterprises, Inc.

  dba Healthsource of Holly Springs

  • Chiropractor
  • Holly Springs, GA
  • NPI 1922822881
  Medicare reassignment NPD

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

{
    "created_epoch": "1730505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1063235679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 HOLLY SPRINGS PKWY STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 HOLLY SPRINGS PKWY STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159013",
            "telephone_number": "770-562-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM JR",
        "first_name": "GUWOIN",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-02",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR011110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent Physical Therapy of Ga LLC
• Independent Physical Therapy of Ga, LLC (Benchmark PT- Holly Springs)
• Independent Physical Therapy of Ga, LLC
• Independent Physical Therapy of Georgia, LLC
• Katherine Renee Ingle, PA-C
• Martin Breland Inman
• Inmotion Counseling LLC
• Innate Abundance
• Innate Universe LLC
• Innovative Home Dialysis of Georgia, LLC

• Chiropractor in Canton, GA
• Providers in Canton, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; 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.