Individual provider Active NPI

Kenneth G Holewinski, DC

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1083714869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2306 Issued in GA
Practice address
755 Simpson St
Atlanta, GA 30314
Phone
(404) 525-3772
Fax
(404) 525-3773
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2306 GA Primary
Chiropractor 111N00000X 1667 AL

Addresses

Primary practice location

755 Simpson St
Atlanta, GA 30314

Mailing address

755 Simpson St
Atlanta, GA 30314
Phone (404) 525-3772

Other identifiers 1

IdentifierTypeStateIssuer
50012988OtherGARAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230818003476 GA Practitioner - Chiropractic 2668834805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grant Chiropractic of Blue Ridge, PCGroup PAC ID 8426214081, 2 clinicians

Practice addresses (Care Compare)

2710 E 1St St
Blue Ridge, GA 30513-4510
Phone (706) 632-6574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2306GAMDChiropractor
1667ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Chiropractic of Blue Ridge, PC Chiropractor CurrentSince May 13, 2023 Accepting new patients

Locations

2710 E First St
Blue Ridge, GA 30513
Phone (706) 632-6574

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083714869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SIMPSON ST",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30314",
            "telephone_number": "404-525-3772",
            "fax_number": "404-525-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SIMPSON ST",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30314",
            "telephone_number": "404-525-3772",
            "fax_number": "404-525-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLEWINSKI",
        "first_name": "KENNETH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "2306",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1667",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "50012988",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.