Individual provider Active NPI

Neda Nore, DC

  • Chiropractor
  • Lilburn, GA
National Provider Identifier
1265982144
Registry record updated Jul 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009686 Issued in GA
Practice address
651 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-6838
Phone
(770) 925-0088
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009686 GA Primary

Addresses

Primary practice location

651 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-6838

Mailing address

651 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-6838
Phone (517) 402-9662

Other practice location 1

4910 Lavista Rd
Tucker, GA 30084-4403
Phone (770) 491-3639

Other practice location 2

1867 Independence Sq Ste 100
Dunwoody, GA 30338-5152
Phone (404) 789-0352

Other identifiers 1

IdentifierTypeStateIssuer
CHIR009686OtherGASTATE LICENSE

Other names 1

  • Neda Nouraei-Hesari Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170515000733 GA Practitioner - Chiropractic 7517244833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4910 Lavista Rd
Tucker, GA 30084-4403
Phone (770) 491-3639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009686GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Chiropractic Clinic, LLC Chiropractor CurrentSince Feb 4, 2024 Accepting new patients
Progressive Care of Gwinnett LLC Chiropractor CurrentSince Oct 26, 2018 Accepting new patients

Locations

651 Indian Trl Lilburn Rd NW
Lilburn, GA 30047
Phone (517) 402-9662

670 Indian Trl Lilburn Rd NW
Ste D
Lilburn, GA 30047
Phone (770) 925-0088

651 Indian Trl Lilburn Rd NW
#R
Lilburn, GA 30047

4910 Lavista Rd
Tucker, GA 30084
Phone (770) 491-3639

Organizations & group practices 2

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": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720828800000",
    "number": "1265982144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 INDIAN TRAIL LILBURN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476838",
            "telephone_number": "517-402-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 INDIAN TRAIL LILBURN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476838",
            "telephone_number": "770-925-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4910 Lavista Rd",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300844403",
            "country_code": "US",
            "telephone_number": "770-491-3639",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1867 Independence Sq Ste 100",
            "address_purpose": "LOCATION",
            "city": "Dunwoody",
            "state": "GA",
            "postal_code": "303385152",
            "country_code": "US",
            "telephone_number": "404-789-0352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORE",
        "first_name": "NEDA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CHIR009686",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NEDA",
            "last_name": "NOURAEI-HESARI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2024; 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.