Individual provider Active NPI

Mohsen Nikdel, DC

  • Chiropractor
  • Roswell, GA
National Provider Identifier
1114532066
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010411 Issued in GA
Practice address
11205 Alpharetta Hwy Ste D4
Roswell, GA 30076-5645
Phone
(404) 662-2191
NPI assigned
Sep 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010411 GA Primary

Addresses

Primary practice location

11205 Alpharetta Hwy Ste D4
Roswell, GA 30076-5645

Mailing address

11205 Alpharetta Hwy Ste D4
Roswell, GA 30076-5645
Phone (404) 662-2191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200925001607 GA Practitioner - Chiropractic 9830518737 Reassigns benefits to 1 organization
Practice locations: Roswell, GA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11205 Alpharetta Hwy
Suite C2
Roswell, GA 30076-1443
Phone (404) 662-2191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR010411GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
United Injury Specialist LLC Chiropractor CurrentSince Apr 1, 2025 Accepting new patients
Pars Health Clinic LLC Chiropractor CurrentSince Sep 13, 2020 Accepting new patients

Locations

11205 Alpharetta Hwy
Ste C2
Roswell, GA 30076
Phone (404) 662-2191

11205 Alpharetta Hwy
Ste D4
Roswell, GA 30076
Phone (404) 662-2191

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, 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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1114532066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11205 ALPHARETTA HWY STE D4",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765645",
            "telephone_number": "404-662-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11205 ALPHARETTA HWY STE D4",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765645",
            "telephone_number": "404-662-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKDEL",
        "first_name": "MOHSEN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.