Individual provider Active NPI

Eric A Jablonski, DC

  • Chiropractor
  • Martinez, GA
National Provider Identifier
1255403481
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5326 Issued in GA
Practice address
211 Bobby Jones Expy
Ste C
Martinez, GA 30907-5250
Phone
(706) 860-3355
Fax
(706) 860-8765
NPI assigned
Nov 14, 2006
Last updated
Apr 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5326 GA Primary

Addresses

Primary practice location

211 Bobby Jones Expy
Ste C
Martinez, GA 30907-5250

Mailing address

211 Bobby Jones Expy
Ste C
Martinez, GA 30907-5250
Phone (706) 860-3355

Other identifiers 2

IdentifierTypeStateIssuer
20270G5260OtherGAMEDICARE GROUP ACTION MEDICAL CENTER LLC
GRP3167OtherGAMEDICARE GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110914000550 GA Practitioner - Chiropractic 0840353389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Action Medical Center, LLCGroup PAC ID 5496818932, 7 clinicians

Practice addresses (Care Compare)

211 Bobby Jones Expy
Suite C
Martinez, GA 30907-5253
Phone (706) 836-6218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5326GAMDChiropractor

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1255403481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BOBBY JONES EXPY",
            "address_2": "STE C",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309075250",
            "telephone_number": "706-860-3355",
            "fax_number": "706-860-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 BOBBY JONES EXPY",
            "address_2": "STE C",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309075250",
            "telephone_number": "706-860-3355",
            "fax_number": "706-860-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABLONSKI",
        "first_name": "ERIC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "5326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ACTION MEDICAL CENTER LLC",
            "identifier": "20270G5260",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GRP3167",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.