Individual provider Active NPI

Jagerran Knight-Bryant, DC

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1164189908
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010291 Issued in GA
Practice address
3115 Roswell Rd Ste 204
Marietta, GA 30062-7611
Phone
(770) 756-7741
NPI assigned
Nov 29, 2021
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010291 GA Primary

Addresses

Primary practice location

3115 Roswell Rd Ste 204
Marietta, GA 30062-7611

Mailing address

3115 Roswell Rd Ste 204
Marietta, GA 30062-7611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220223001820 GA Practitioner - Chiropractic 0648664417 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mustard Seed Chiropractic Chiropractor CurrentSince Jan 13, 2022 Accepting new patients

Locations

3115 Roswell Rd
Ste 204
Marietta, GA 30062
Phone (404) 383-0778

1060 Windy Hill Rd SE
Ste 209
Smyrna, GA 30080
Phone (678) 403-1796

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, 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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1164189908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 ROSWELL RD STE 204",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 ROSWELL RD STE 204",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627611",
            "telephone_number": "770-756-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT-BRYANT",
        "first_name": "JAGERRAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.