Organization Active NPI

Injury and Rehab Centers of Georgia, LLC

  • Chiropractor
  • Norcross, GA
National Provider Identifier
1063945947
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005705 Issued in GA
Legal business name
INJURY AND REHAB CENTERS OF GEORGIA, LLC
Practice address
1568 Indian Trail Lilburn Rd Ste 105
Norcross, GA 30093-2613
Phone
(770) 696-2404
Fax
(770) 696-2135
NPI assigned
Apr 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Maria Leyva-Izaguirre
Title
Partner
Phone
(770) 696-2404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR005705 GA Primary

Addresses

Primary practice location

1568 Indian Trail Lilburn Rd Ste 105
Norcross, GA 30093-2613

Mailing address

1568 Indian Trail Lilburn Rd Ste 105
Norcross, GA 30093-2613
Phone (770) 696-2404

National Provider Directory

National Provider Directory

Locations

1568 Indian Trail Lilburn Rd
Ste 105
Norcross, GA 30093
Phone (770) 696-2404

Practitioners & affiliated clinicians

Practitioners 3

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": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1063945947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 INDIAN TRAIL LILBURN RD STE 105",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932613",
            "telephone_number": "770-696-2404",
            "fax_number": "770-696-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 INDIAN TRAIL LILBURN RD STE 105",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932613",
            "telephone_number": "770-696-2404",
            "fax_number": "770-696-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INJURY AND REHAB CENTERS OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "LEYVA-IZAGUIRRE",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "770-696-2404"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

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