Organization Active NPI

Total Health, LLC

  • Chiropractor
  • Jonesboro, GA
National Provider Identifier
1063950004
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
TOTAL HEALTH, LLC
Practice address
769 Millstone Dr
Jonesboro, GA 30238-4127
Phone
(678) 610-1777
Fax
(678) 669-1867
NPI assigned
Feb 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Authorized official

Name
Dr. Stacy D Roberts, DCNPI 1720056476
Title
Owner/Doctor of Chiropractic
Phone
(314) 504-6903

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 GA Primary

Addresses

Primary practice location

769 Millstone Dr
Jonesboro, GA 30238-4127

Mailing address

769 Millstone Dr
Jonesboro, GA 30238-4127
Phone (314) 504-6903

Other practice location 1

148 Georgia Ave E Ste A
Fayetteville, GA 30214-1616
Phone (314) 504-6903

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200730002132 GA Part B Supplier - Clinic/Group Practice 3577998921 Receives reassigned benefits from 1 practitioner
Practice locations: Fayetteville, GA

National Provider Directory

National Provider Directory

Locations

148 Georgia Ave E
Ste A
Fayetteville, GA 30214
Phone (314) 504-6903

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": "1486684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1063950004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 MILLSTONE DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302384127",
            "telephone_number": "314-504-6903",
            "fax_number": "678-669-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 MILLSTONE DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302384127",
            "telephone_number": "678-610-1777",
            "fax_number": "678-669-1867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "148 Georgia Ave E Ste A",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302141616",
            "country_code": "US",
            "telephone_number": "314-504-6903",
            "fax_number": "678-669-1867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TOTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-10",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "314-504-6903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.