Organization Active NPI

Kondyles Chiropractic PC

  • Chiropractor
  • Rome, GA
National Provider Identifier
1124272711
Registry record updated Nov 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007849 Issued in GA
Legal business name
KONDYLES CHIROPRACTIC PC
Practice address
1607B Martha Berry Blvd NW
Rome, GA 30165-1621
Phone
(706) 235-6467
NPI assigned
Nov 9, 2008
Last updated
Nov 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2008

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

Authorized official

Name
Dr. Andrew Kondyles, DCNPI 1548322340
Title
Owner
Phone
(706) 235-6467

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR007849 GA Primary

Addresses

Primary practice location

1607B Martha Berry Blvd NW
Rome, GA 30165-1621

Mailing address

1607B Martha Berry Blvd NW
Rome, GA 30165-1621
Phone (706) 235-6467

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081125000712 GA Part B Supplier - Clinic/Group Practice 7911067681 Receives reassigned benefits from 1 practitioner
Practice locations: Rome, GA

National Provider Directory

National Provider Directory

Locations

1607 Martha Berry Blvd NW
#B
Rome, GA 30165
Phone (706) 235-6467

1607B Martha Berry Blvd NW
Rome, GA 30165
Phone (404) 235-6467

1607B Martha Berry Blvd NW
Ste B
Rome, GA 30165
Phone (706) 235-6467

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1226188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226188800000",
    "number": "1124272711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607B MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651621",
            "telephone_number": "706-235-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607B MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651621",
            "telephone_number": "706-235-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONDYLES CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-09",
        "last_updated": "2008-11-09",
        "status": "A",
        "authorized_official_last_name": "KONDYLES",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-235-6467",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2008; 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.