Mathew Autera, DC
Individual provider Active NPI Chiropractor · Peachtree City, GA
NPI 1093894396 · NPPES record last updated Sep 10, 2014
Key facts
- NPI
- 1093894396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4867 (GA)
- Practice address
- 1952 Highway 54 W
Peachtree City, GA 30269-4781 - Phone
- (770) 487-5211
- Fax
- (770) 487-5950
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1952 Hwy 54 W
Peachtree City, GA 30269
Phone (770) 487-5211
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120418000708 | GA | Practitioner - Chiropractic | 4789845751 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4867 | GA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mja Chiropractic, Inc | Chiropractor | Current |
Accepting new patients |
Locations
1952 Highway 54 W
Peachtree Cty, GA 30269
Phone (770) 487-5211
Interoperability endpoints
- matt@ahc0015.direct.chirotouch.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4867 | GA | Yes |
Addresses
Primary practice location
1952 Highway 54 W
Peachtree City, GA 30269-4781
Mailing address
PO Box 2466
Peachtree City, GA 30269-0466
Phone (770) 487-5211
Other providers in Peachtree City, GA
- Atlanta Neurospine Institute, PC
- Atlanta South Physical Therapy, Inc
- Varsha Atuluru
- Audiology Services Company USA, LLC
- Keily Lynn Austin
- Avalon Hospice LLC
- Venkata Naga Ratna Krishna M Avva
- Ays Medical Supplies LLC
- Thomasina L. Bailey
- Alison Baker
All providers in Peachtree City, GA · Chiropractor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.