Randel Everette Whitehead Jr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR009473 Issued in GA

Practice address

418 Bradley St
Carrollton, GA 30117-3301

Phone

(770) 214-9146

Fax

(770) 214-9166

NPI assigned

Mar 18, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Chiropractic Clinic, PCGroup PAC ID 6800998741, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advantage Chiropractic Clinic, PC

  • Chiropractor
  • Auburn, AL
  • NPI 1225104573
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1235522004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 BRADLEY ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173301",
            "telephone_number": "770-214-9146",
            "fax_number": "770-214-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 BRADLEY ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173301",
            "telephone_number": "770-214-9146",
            "fax_number": "770-214-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "RANDEL",
        "middle_name": "EVERETTE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-18",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wguasc, LLC
• Stacie Whalen
• Richard Whitaker, M.D.
• White Coat Sciences LLC
• James B White, MD
• Edwin Glenn Whitney, MD
• Joseph Matthew Whittington
• Logan Wigginton
• Janice May Wilder, NP
• Danielle Wildes, LMFT

• Chiropractor in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.