Organization Active NPI

Demyen Family Chiropractic Inc

  • Chiropractor
  • Canton, GA
National Provider Identifier
1063748366
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO006748 Issued in GA
Legal business name
DEMYEN FAMILY CHIROPRACTIC INC
Practice address
6199 Hickory Flat Hwy
Suite 142
Canton, GA 30115-7255
Phone
(770) 720-2222
Fax
(866) 591-5729
NPI assigned
Oct 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Dr. Joseph T Demyen Jr., D.C.NPI 1770789257
Title
President
Phone
(770) 720-2222

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIRO006748 GA Primary

Addresses

Primary practice location

6199 Hickory Flat Hwy
Suite 142
Canton, GA 30115-7255

Mailing address

6199 Hickory Flat Hwy
Suite 142
Canton, GA 30115-7255
Phone (770) 720-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091026000188 GA Part B Supplier - Clinic/Group Practice 1052458908 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, GA

National Provider Directory

National Provider Directory

Locations

6199 Hickory Flat Hwy
Ste 142
Canton, GA 30115
Phone (770) 720-2222

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1063748366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6199 HICKORY FLAT HWY",
            "address_2": "SUITE 142",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157255",
            "telephone_number": "770-720-2222",
            "fax_number": "866-591-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6199 HICKORY FLAT HWY",
            "address_2": "SUITE 142",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157255",
            "telephone_number": "770-720-2222",
            "fax_number": "866-591-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMYEN FAMILY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "DEMYEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-720-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO006748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.