Individual provider Active NPI

John Herbert Kent Jr., DC

  • Chiropractor
  • Lagrange, GA
National Provider Identifier
1164682993
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR08331 Issued in GA
Practice address
1505 Lafayette Pkwy
Lagrange, GA 30241-2513
Phone
(706) 882-5737
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR08331 GA Primary

Addresses

Primary practice location

1505 Lafayette Pkwy
Lagrange, GA 30241-2513

Mailing address

1505 Lafayette Pkwy
Lagrange, GA 30241-2513
Phone (706) 882-5737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101216000772 GA Practitioner - Chiropractic 4587852660 Reassigns benefits to 1 organization
I20190319000162 AL Practitioner - Chiropractic 4587852660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1602 20TH Ave
Phenix City, AL 36867-3714
Phone (334) 297-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR08331GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kent Chiropractic Clinic Chiropractor CurrentSince Dec 12, 2018 Accepting new patients
Back to Life Chiropractic Center II Chiropractor CurrentSince Dec 14, 2025 Accepting new patients
Back to Life Chiropractic Center Inc Chiropractor CurrentSince Apr 24, 2013 Accepting new patients
Athens Chiropractic & Therapy Chiropractor Past Accepting new patients

Locations

1602 20th Ave
Phenix City, AL 36867
Phone (334) 297-2225

1505 Lafayette Pkwy
Lagrange, GA 30241
Phone (706) 882-5737

Organizations & group practices 4

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1164682993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412513",
            "telephone_number": "706-882-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412513",
            "telephone_number": "706-882-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "JOHN",
        "middle_name": "HERBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR08331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.