Individual provider Active NPI

Jorge A Bueno, D.C

  • Nutrition Chiropractor
  • Acworth, GA
National Provider Identifier
1114078474
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
007057 Issued in GA
Practice address
2161 Cedarcrest Rd Ste 115
Acworth, GA 30101-6404
Phone
(678) 574-4878
Fax
(678) 574-4899
NPI assigned
Jan 15, 2007
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 007057 GA Primary

Addresses

Primary practice location

2161 Cedarcrest Rd Ste 115
Acworth, GA 30101-6404

Mailing address

2161 Cedarcrest Rd Ste 115
Acworth, GA 30101-6404
Phone (678) 574-4878

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040405000067 GA Practitioner - Chiropractic 6002809480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5977 Stewart Pkwy
Douglasville, GA 30135-2371
Phone (770) 942-5575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jorge a. Bueno Chiropractic LLC Nutrition CurrentSince Jun 1, 2009 Accepting new patients
A Family Practice and Wellness Center PastSince Mar 26, 2011 Accepting new patients
Cedarcrest Medical and Rehabilitation Past Accepting new patients
Stewart Mill Medical & Rehabilitation Center LLC Past Accepting new patients

Locations

2161 Cedarcrest Rd
Ste 115
Acworth, GA 30101
Phone (678) 574-4878

1350 Joe Frank Harris Pkwy SE
Ste 102
Cartersville, GA 30120

309 E Main St
Cartersville, GA 30120
Phone (770) 386-5262

5977 Stewart Pkwy
Douglasville, GA 30135
Phone (770) 942-5575

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1114078474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2161 CEDARCREST RD STE 115",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301016404",
            "telephone_number": "678-574-4878",
            "fax_number": "678-574-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2161 CEDARCREST RD STE 115",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301016404",
            "telephone_number": "678-574-4878",
            "fax_number": "678-574-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENO",
        "first_name": "JORGE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "GA",
            "license": "007057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.