Individual provider Active NPI

Jordan Scott Haugh, D.C.

  • Chiropractor
  • Hiram, GA
National Provider Identifier
1184843799
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIROO5322 Issued in GA
Practice address
3655 Macland Rd
Suite C
Hiram, GA 30141-2226
Phone
(770) 439-6063
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIROO5322 GA Primary

Addresses

Primary practice location

3655 Macland Rd
Suite C
Hiram, GA 30141-2226

Mailing address

3060 Hallman Cir SW
Marietta, GA 30064-2499
Phone (770) 420-9538

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120409000371 GA Practitioner - Chiropractic 7911168554 Practice locations: Hiram, GA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3655 Macland Rd
Suite C
Hiram, GA 30141-2226
Phone (770) 439-6063

3655 Macland Rd C
Hiram, GA 30141-2226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIROO5322GAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184843799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 HALLMAN CIR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642499",
            "telephone_number": "770-420-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 MACLAND RD",
            "address_2": "SUITE C",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412226",
            "telephone_number": "770-439-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGH",
        "first_name": "JORDAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIROO5322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.