Individual provider Active NPI

Ian Calk, DC

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1265909162
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010130 Issued in GA
Practice address
3000 Johnson Ferry Rd Ste 102
Marietta, GA 30062-5697
Phone
(770) 552-7979
Fax
(770) 552-1153
NPI assigned
Oct 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010130 GA Primary

Addresses

Primary practice location

3000 Johnson Ferry Rd Ste 102
Marietta, GA 30062-5697

Mailing address

3000 Johnson Ferry Rd Ste 102
Marietta, GA 30062-5697
Phone (770) 552-7979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190126000062 GA Practitioner - Chiropractic 6901143130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Raymond Gaskey D.C. P.C.Group PAC ID 7618993684, 4 clinicians

Practice addresses (Care Compare)

3225 Shallowford Rd
Suite 810
Marietta, GA 30062-7028
Phone (770) 552-7979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Raymond Gaskey D.C. P.C. CurrentSince Oct 30, 2018 Accepting new patients

Locations

3000 Johnson Ferry Rd
Ste 102
Marietta, GA 30062
Phone (770) 552-7979

3225 Shallowford Rd
Ste 810
Marietta, GA 30062
Phone (770) 552-7979

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1265909162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 JOHNSON FERRY RD STE 102",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625697",
            "telephone_number": "770-552-7979",
            "fax_number": "770-552-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 JOHNSON FERRY RD STE 102",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625697",
            "telephone_number": "770-552-7979",
            "fax_number": "770-552-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALK",
        "first_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.