Individual provider Active NPI

Justin Thomas Kenney, D.C.

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1174823546
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008741 Issued in GA
Practice address
99 Weatherstone Dr
Suite 940
Woodstock, GA 30188-7005
Phone
(678) 388-7670
Fax
(678) 388-7671
NPI assigned
Nov 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR008741 GA Primary

Addresses

Primary practice location

99 Weatherstone Dr
Suite 940
Woodstock, GA 30188-7005

Mailing address

99 Weatherstone Dr
Suite 940
Woodstock, GA 30188-7005
Phone (678) 388-7670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1174823546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 WEATHERSTONE DR",
            "address_2": "SUITE 940",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887005",
            "telephone_number": "678-388-7670",
            "fax_number": "678-388-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 WEATHERSTONE DR",
            "address_2": "SUITE 940",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887005",
            "telephone_number": "678-388-7670",
            "fax_number": "678-388-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "JUSTIN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.