Justin Kersten, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CHIR010493 Issued in GA

Practice address

1834 S Cobb Industrial Blvd SE
Smyrna, GA 30082-4908

Phone

(404) 594-5809

NPI assigned

Aug 24, 2021

Last updated

Aug 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• LPC Alpharetta LLC

  dba Living Proof Chiropractic

  • Chiropractor
  • Alpharetta, GA
  • NPI 1033980222
  Medicare reassignment NPD

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1114694411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 MCLINDEN AVE SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804142",
            "telephone_number": "586-744-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 S COBB INDUSTRIAL BLVD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824908",
            "telephone_number": "404-594-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSTEN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR010493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kay's Doula Support Services
• Keiko Personal Care Systems, Inc.
• Livia O Kell
• Timothy B Kennedy, MD
• Kerisa Harriott DMD P.C. (RenewALL Orthodontics)
• Sherrice Key
• Ed Keyes Jr.
• Sanjay L Khant, MD
• Joseph Khouri, MD
• Kidz Therapy Spot

• Sports Physician Chiropractor in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Sports Physician Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.