Individual provider Active NPI

Caleb Elijah Keran, DC

  • Chiropractor
  • Tucker, GA
National Provider Identifier
1275098527
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO20251 Issued in GA
Practice address
2347 Brockett Rd
Tucker, GA 30084-4474
Phone
(770) 938-4606
NPI assigned
Jan 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO20251 GA Primary

Addresses

Primary practice location

2347 Brockett Rd
Tucker, GA 30084-4474

Mailing address

540 Indian Acres CT
Tucker, GA 30084-1619
Phone (770) 570-0796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO20251GAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1275098527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 INDIAN ACRES CT",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300841619",
            "telephone_number": "770-570-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 BROCKETT RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844474",
            "telephone_number": "770-938-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERAN",
        "first_name": "CALEB",
        "middle_name": "ELIJAH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO20251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.