NPIMap

Organization Active NPI

Crossroads Spine & Wellness,LLC

  • Chiropractor
  • Braselton, GA
National Provider Identifier
1245775501
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR002968 Issued in GA
Legal business name
CROSSROADS SPINE & WELLNESS,LLC
Practice address
5391 Highway 53
Suite 108
Braselton, GA 30517-3135
Phone
(706) 654-2400
NPI assigned
Dec 22, 2016
Last updated
Jan 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Authorized official

Name
Dr. Randy L McSkulin, D.C.NPI 1619048915
Title
Dr/Owner
Phone
(706) 654-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR002968 GA Primary

Addresses

Primary practice location

5391 Highway 53
Suite 108
Braselton, GA 30517-3135

Mailing address

5391 Highway 53
Suite 108
Braselton, GA 30517-3135
Phone (706) 654-2400

Other names 1

  • Crossroads Spine & Wellness, LLC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1482364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1245775501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5391 HIGHWAY 53",
            "address_2": "SUITE 108",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305173135",
            "telephone_number": "706-654-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5391 HIGHWAY 53",
            "address_2": "SUITE 108",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305173135",
            "telephone_number": "706-654-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS SPINE & WELLNESS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-22",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "MCSKULIN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DR/OWNER",
        "authorized_official_telephone_number": "706-654-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR002968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Spine & Wellness, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Braselton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.