Organization Active NPI

Billingsley & Luckett Chiropractic & Rehab. PC

  • Rehabilitation Chiropractor
  • Covington, GA
National Provider Identifier
1245426097
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CHIR001570 Issued in GA
Legal business name
BILLINGSLEY & LUCKETT CHIROPRACTIC & REHAB. PC
Practice address
3289 Salem Rd
Covington, GA 30016-1863
Phone
(770) 760-1396
Fax
(770) 760-7904
NPI assigned
Sep 14, 2007
Last updated
Sep 14, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

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

Authorized official

Name
Ms. Mary Ann Luckett, D.C.,NPI 1164566840
Title
Coowner
Phone
(770) 760-1396

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X CHIR001570 GA Primary

Addresses

Primary practice location

3289 Salem Rd
Covington, GA 30016-1863

Mailing address

3289 Salem Rd
Covington, GA 30016-1863
Phone (770) 760-1396

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040701001062 GA Part B Supplier - Clinic/Group Practice 4284611815 Receives reassigned benefits from 2 practitioners
Practice locations: Covington, GA

National Provider Directory

National Provider Directory

Locations

3289 Salem Rd
Covington, GA 30016
Phone (770) 760-1396

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1245426097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3289 SALEM RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300161863",
            "telephone_number": "770-760-1396",
            "fax_number": "770-760-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3289 SALEM RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300161863",
            "telephone_number": "770-760-1396",
            "fax_number": "770-760-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILLINGSLEY & LUCKETT CHIROPRACTIC & REHAB. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "LUCKETT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "COOWNER",
        "authorized_official_telephone_number": "770-760-1396",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.C.,"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR001570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.