Individual provider Active NPI

Joshua Alan Kolonick, D.C.

  • Chiropractor
  • Kennesaw, GA
National Provider Identifier
1215048863
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007735 Issued in GA
Practice address
1301 Shiloh Rd NW
Suite 1310
Kennesaw, GA 30144-7147
Phone
(770) 420-8818
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

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 CHIR007735 GA Primary

Addresses

Primary practice location

1301 Shiloh Rd NW
Suite 1310
Kennesaw, GA 30144-7147

Mailing address

1301 Shiloh Rd NW
Suite 1310
Kennesaw, GA 30144-7147
Phone (770) 420-8818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041213000347 GA Practitioner - Chiropractic 3375500259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1301 Shiloh Rd NW
Suite 1310
Kennesaw, GA 30144-7164
Phone (770) 420-8818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR007735GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kolonick Chiropractic, PC Chiropractor CurrentSince Sep 11, 2006 Accepting new patients
Gana Corporation Chiropractor PastSince Sep 11, 2006 Accepting new patients

Locations

1301 Shiloh Rd NW
Ste 1310
Kennesaw, GA 30144
Phone (770) 420-0083

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215048863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SHILOH RD NW",
            "address_2": "SUITE 1310",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447147",
            "telephone_number": "770-420-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SHILOH RD NW",
            "address_2": "SUITE 1310",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447147",
            "telephone_number": "770-420-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLONICK",
        "first_name": "JOSHUA",
        "middle_name": "ALAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, 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.