Organization Active NPI

Chiropractic Wellness Center P C

  • Chiropractor
  • Johns Creek, GA
National Provider Identifier
1093021818
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR006228 Issued in GA
Legal business name
CHIROPRACTIC WELLNESS CENTER P C
Practice address
6385 McGinnis Ferry Rd Ste 201
Johns Creek, GA 30005-3672
Phone
(770) 623-6880
Fax
(770) 623-6440
NPI assigned
Aug 31, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Authorized official

Name
Dr. Joseph Fanning, D.C.NPI 1942343165
Title
President
Phone
(770) 623-6880

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 CHIR006228 GA Primary

Addresses

Primary practice location

6385 McGinnis Ferry Rd Ste 201
Johns Creek, GA 30005-3672

Mailing address

6385 McGinnis Ferry Rd Ste 201
Johns Creek, GA 30005-3672
Phone (770) 623-6880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160901001397 GA Part B Supplier - Clinic/Group Practice 8628260163 Receives reassigned benefits from 1 practitioner
Practice locations: Johns Creek, GA

National Provider Directory

National Provider Directory

Locations

4375 Johns Creek Pkwy
Ste 330
Suwanee, GA 30024
Phone (770) 277-9222

Practitioners & affiliated clinicians

Practitioners 2

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": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635811200000",
    "number": "1093021818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 MCGINNIS FERRY RD STE 201",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300053672",
            "telephone_number": "770-623-6880",
            "fax_number": "770-623-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6385 MCGINNIS FERRY RD STE 201",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300053672",
            "telephone_number": "770-623-6880",
            "fax_number": "770-623-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC WELLNESS CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A",
        "authorized_official_last_name": "FANNING",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-623-6880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.