Individual provider Active NPI

Amanda Holden, DC

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1184456790
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5588 Issued in NC
Practice address
4343 Shallowford Rd Ste 460
Marietta, GA 30062-5069
Phone
(423) 833-5093
NPI assigned
Aug 14, 2024
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9536 GA
Chiropractor 111N00000X 5588 NC Primary

Addresses

Primary practice location

4343 Shallowford Rd Ste 460
Marietta, GA 30062-5069

Mailing address

77 Ivy Cove Rd
Fairview, NC 28730-8630
Phone (423) 833-5093

Other practice location 1

77 Ivy Cove Rd
Fairview, NC 28730-8630
Phone (423) 833-5093

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9536GAMDChiropractor
5588NCMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1184456790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 IVY COVE RD",
            "city": "FAIRVIEW",
            "state": "NC",
            "postal_code": "287308630",
            "telephone_number": "423-833-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SHALLOWFORD RD STE 460",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625069",
            "telephone_number": "423-833-5093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Ivy Cove Rd",
            "address_purpose": "LOCATION",
            "city": "Fairview",
            "state": "NC",
            "postal_code": "287308630",
            "country_code": "US",
            "telephone_number": "423-833-5093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "AMANDA",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "9536",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5588",
            "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 Aug 14, 2024; 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.