Organization Active NPI

Nam Ki Chiropractic L.L.C

  • Chiropractor
  • Duluth, GA
National Provider Identifier
1104236777
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008082 Issued in GA
Legal business name
NAM KI CHIROPRACTIC L.L.C
Practice address
3230 Steve Reynolds Blvd Ste 208
Duluth, GA 30096
Phone
(770) 418-1110
NPI assigned
May 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Authorized official

Name
Kikwang NamNPI 1538548730
Title
Dr.Nam
Phone
(770) 418-1110

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 CHIR008082 GA Primary

Addresses

Primary practice location

3230 Steve Reynolds Blvd Ste 208
Duluth, GA 30096

Mailing address

3230 Steve Reynolds Blvd Ste 208
Duluth, GA 30096-8832
Phone (770) 418-1110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181003000123 GA Part B Supplier - Clinic/Group Practice 3476805425 Receives reassigned benefits from 1 practitioner
Practice locations: Duluth, GA

National Provider Directory

National Provider Directory

Locations

3230 Steve Reynolds Blvd
Ste 109
Duluth, GA 30096
Phone (770) 418-1110

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": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1104236777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 STEVE REYNOLDS BLVD STE 208",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968832",
            "telephone_number": "770-418-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 STEVE REYNOLDS BLVD STE 208",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-418-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAM KI CHIROPRACTIC L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "NAM",
        "authorized_official_first_name": "KIKWANG",
        "authorized_official_title_or_position": "DR.NAM",
        "authorized_official_telephone_number": "770-418-1110"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.