Prospine Wellness & Injury Care PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PROSPINE WELLNESS & INJURY CARE PC

Practice address

4200 Wade Green Rd NW Ste 204
Kennesaw, GA 30144-1808

Phone

(602) 430-6994

NPI assigned

Feb 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Raymond D Taylor, DCNPI 1235799354

Title

President

Phone

(602) 430-6994

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond D Taylor, DC

  • Chiropractor
  • Kennesaw, GA
  • NPI 1235799354
  Medicare reassignment NPD Authorized official
• Nicole Forte

  • Chiropractor
  • Kennesaw, GA
  • NPI 1871112714
  NPD
• Stephen Kelly Green, D.C.

  • Chiropractor
  • Kennesaw, GA
  • NPI 1770508145
  NPD
• David Anthony Pelosi, DC

  • Chiropractor
  • Providence, RI
  • NPI 1376719146
  NPD (past)

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

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581206400000",
    "number": "1194357046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 HARRIS FARMS WAY",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068017",
            "telephone_number": "602-430-6994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WADE GREEN RD NW STE 204",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441808",
            "telephone_number": "602-430-6994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPINE WELLNESS & INJURY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-09",
        "last_updated": "2020-02-09",
        "certification_date": "2020-02-09",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-430-6994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Medical Transport LLC
• Jacqueline Proborowski, BCBA
• Prodigy Health Systems Inc.,
• Progressive Care Associates, Inc.
• Jennifer Cynthia Prospere, LCSW
• Crystaline Joi Prothro, NP-C
• Providence Counseling Services LLC
• April Pruitt, RN
• Pruittplace - Kennesaw, LLC
• Psychiatric Healing for All LLC

• All providers in Kennesaw, GA
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2020; 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.