Individual provider Active NPI

Angel Tribuno, D.C.

  • Chiropractor
  • Hiram, GA
National Provider Identifier
1104853290
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5022 Issued in GA
Practice address
44 Darbys Crossing Dr
Suite 102a
Hiram, GA 30141-6008
Phone
(770) 439-8393
Fax
(815) 642-9045
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5022 GA Primary

Addresses

Primary practice location

44 Darbys Crossing Dr
Suite 102a
Hiram, GA 30141-6008

Mailing address

44 Darbys Crossing Dr
Suite 102a
Hiram, GA 30141-6008
Phone (770) 439-8393

Other identifiers 1

IdentifierTypeStateIssuer
11353066OtherCAQH

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
5022GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pizza Clinic of Chiropractic Chiropractor PastSince Aug 2, 2017 Accepting new patients
Turning Point Chiropractic Center, Inc PastSince Aug 26, 2002 Accepting new patients

Organizations & group practices 2

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1104853290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 DARBYS CROSSING DR",
            "address_2": "SUITE 102A",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301416008",
            "telephone_number": "770-439-8393",
            "fax_number": "815-642-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DARBYS CROSSING DR",
            "address_2": "SUITE 102A",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301416008",
            "telephone_number": "770-439-8393",
            "fax_number": "815-642-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIBUNO",
        "first_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "5022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11353066",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.