Active NPI
Ethan Cole Trawick, DC
- Chiropractor
- Cedartown, GA
National Provider Identifier
1114424603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR010049
- Practice address
- 541 N Main St
Cedartown, GA 30125-2301 - Phone
- (770) 748-3537
- NPI assigned
- Apr 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR010049 | GA | Primary |
Addresses
Primary practice location
541 N Main St
Cedartown, GA 30125-2301
Mailing address
236 Cherokee Rd
Cedartown, GA 30125-4396
Phone (770) 324-7277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181031001983 | GA | Practitioner - Chiropractic | 0345593760 | Practice locations: Cedartown, GA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
541 N Main St
Cedartown, GA 30125-2301
Phone (770) 324-7277
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR010049 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523318400000",
"number": "1114424603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "236 CHEROKEE RD",
"city": "CEDARTOWN",
"state": "GA",
"postal_code": "301254396",
"telephone_number": "770-324-7277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 N MAIN ST",
"city": "CEDARTOWN",
"state": "GA",
"postal_code": "301252301",
"telephone_number": "770-748-3537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAWICK",
"first_name": "ETHAN",
"middle_name": "COLE",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-10",
"last_updated": "2018-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR010049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedartown, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
- 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.