Organization Active NPI

Amato Chiropractic Clinic

  • Chiropractor
  • Kingsland, GA
National Provider Identifier
1063554855
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005497 Issued in GA
Legal business name
AMATO CHIROPRACTIC CLINIC
Practice address
2475 Village Dr
Suite 108
Kingsland, GA 31548-6728
Phone
(912) 882-8888
Fax
(912) 882-8889
NPI assigned
Feb 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Matthew Amato, D.C.NPI 1689744609
Title
Chiropractor
Phone
(912) 882-8888

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR005497 GA Primary
Chiropractor 111N00000X CHIR005559 GA

Addresses

Primary practice location

2475 Village Dr
Suite 108
Kingsland, GA 31548-6728

Mailing address

2475 Village Dr
Suite 108
Kingsland, GA 31548-6728
Phone (912) 882-8888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120120000194 GA Part B Supplier - Clinic/Group Practice 3072780741 Receives reassigned benefits from 2 practitioners
Practice locations: Kingsland, GA

National Provider Directory

National Provider Directory

Locations

2475 Village Dr
Ste 108
Kingsland, GA 31548
Phone (912) 882-8887

Interoperability endpoints

  • Direct secure messaging: drdavid@acwc0006.direct.chirotouch.md
  • Direct secure messaging: drlesa@acwc0006.direct.chirotouch.md

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063554855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 VILLAGE DR",
            "address_2": "SUITE 108",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486728",
            "telephone_number": "912-882-8888",
            "fax_number": "912-882-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 VILLAGE DR",
            "address_2": "SUITE 108",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486728",
            "telephone_number": "912-882-8888",
            "fax_number": "912-882-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMATO CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMATO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "912-882-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005497",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005559",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.