Individual provider Active NPI

Joseph Stephen Bennett Jr., D.C.

  • Chiropractor
  • Oakwood, GA
National Provider Identifier
1235185117
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2278 Issued in GA
Practice address
4211 Mundy Mill PL
Suite B
Oakwood, GA 30566-2530
Phone
(770) 534-8614
Fax
(770) 534-8169
NPI assigned
May 25, 2006
Last updated
Dec 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2278 GA Primary

Addresses

Primary practice location

4211 Mundy Mill PL
Suite B
Oakwood, GA 30566-2530

Mailing address

4211 Mundy Mill PL
Suite B
Oakwood, GA 30566-2530
Phone (770) 534-8614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110127000764 GA Practitioner - Chiropractic 9335328962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Lincoln Chiropractic College, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4211 Mundy Mill PL
Suite B
Oakwood, GA 30566-2540
Phone (770) 534-8614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2278GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
J. Stephen Bennett Jr. Chiropractor CurrentSince Jul 1, 1966 Accepting new patients

Locations

4211 Mundy Mill Pl
Ste B
Oakwood, GA 30566
Phone (404) 534-8614

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1235185117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 MUNDY MILL PL",
            "address_2": "SUITE B",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305662530",
            "telephone_number": "770-534-8614",
            "fax_number": "770-534-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 MUNDY MILL PL",
            "address_2": "SUITE B",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305662530",
            "telephone_number": "770-534-8614",
            "fax_number": "770-534-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JOSEPH",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "2278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.