Individual provider Active NPI

Chad Dennis Brezinski, D.C.

  • Chiropractor
  • Cartersville, GA
National Provider Identifier
1083670897
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008980 Issued in GA
Practice address
807 West Ave
Suite G
Cartersville, GA 30120-8230
Phone
(770) 334-2126
Fax
(770) 334-2946
NPI assigned
Apr 21, 2006
Last updated
Aug 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 009502 PA
Chiropractor 111N00000X CHIR008980 GA Primary
Chiropractor 111N00000X 7990 AZ

Addresses

Primary practice location

807 West Ave
Suite G
Cartersville, GA 30120-8230

Mailing address

807 West Ave
Suite G
Cartersville, GA 30120-8230
Phone (770) 334-2126

Other identifiers 1

IdentifierTypeStateIssuer
101768479MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7990AZMDChiropractor
009502PAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1083670897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 WEST AVE",
            "address_2": "SUITE G",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208230",
            "telephone_number": "770-334-2126",
            "fax_number": "770-334-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 WEST AVE",
            "address_2": "SUITE G",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208230",
            "telephone_number": "770-334-2126",
            "fax_number": "770-334-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREZINSKI",
        "first_name": "CHAD",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "009502",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008980",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7990",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101768479",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.