Brandi Christine Phavorachith, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR010917 Issued in GA

Practice address

3105 Creekside Village Dr NW Ste 710
Kennesaw, GA 30144-4218

Phone

(678) 996-0373

Fax

(404) 320-6073

NPI assigned

Jan 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Christine Phavorachith Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1164138327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 CREEKSIDE VILLAGE DR NW STE 710",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444218",
            "telephone_number": "678-996-0373",
            "fax_number": "404-320-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 CREEKSIDE VILLAGE DR NW STE 710",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444218",
            "telephone_number": "678-996-0373",
            "fax_number": "404-320-6073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAVORACHITH",
        "first_name": "BRANDI",
        "middle_name": "CHRISTINE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "PHAVORACHITH",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Chiropractor in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.