Individual provider Active NPI

Nailah Asha Smith, D. C.

  • Chiropractor
  • Lithonia, GA
National Provider Identifier
1144377813
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007963 Issued in GA
Practice address
3636 Panola Rd
Ste B
Lithonia, GA 30038-2792
Phone
(770) 733-1381
Fax
(866) 762-9112
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR007963 GA Primary

Addresses

Primary practice location

3636 Panola Rd
Ste B
Lithonia, GA 30038-2792

Mailing address

3636 Panola Rd
Ste B
Lithonia, GA 30038-2792
Phone (770) 733-1381

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080624000659 GA Practitioner - Chiropractic 4284705971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3636 Panola Rd B
Lithonia, GA 30038-2792
Phone (770) 733-1381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR007963GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Full Body Rejuvenetion Center, LLC Chiropractor CurrentSince Aug 21, 2007 Accepting new patients

Locations

3636 Panola Rd
Ste B
Stonecrest, GA 30038
Phone (678) 609-1586

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1144377813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 PANOLA RD",
            "address_2": "STE B",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382792",
            "telephone_number": "770-733-1381",
            "fax_number": "866-762-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 PANOLA RD",
            "address_2": "STE B",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382792",
            "telephone_number": "770-733-1381",
            "fax_number": "866-762-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NAILAH",
        "middle_name": "ASHA",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.