Active NPI
Khaled M Abouhaif, D.C.
- Chiropractor
- Woodstock, GA
National Provider Identifier
1275562175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR008019
- Practice address
- 310 Gold Creek TRL
Ste 100
Woodstock, GA 30188-5403 - Phone
- (770) 926-9495
- Fax
- (770) 926-9284
- NPI assigned
- Jul 2, 2006
- Last updated
- Feb 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301007348 | MI | |
| Chiropractor | 111N00000X | CHIR008019 | GA | Primary |
Addresses
Primary practice location
310 Gold Creek TRL
Ste 100
Woodstock, GA 30188-5403
Mailing address
919 Dual Hall CT
Powder Springs, GA 30127-6970
Phone (770) 419-1028
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133505 | Other | MI | PREFERRED CHOICES |
| 350045598 | Other | MI | MEDICARE RAILROAD |
| 4400101 | Other | MI | PHYSICIANS HEALTHPLAN |
| 0980481 | Other | MI | HEALTHPLUS |
| 5183617 | Other | MI | AETNA |
| 1016842-0001 | Other | MI | WELLNESS |
| 383374689 | Other | MI | PPOM |
| 1002612 | Other | MI | MCLAREN HEALTH |
| KA007348 | Other | MI | BCBSM |
| 3334395 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13190 Hwy 92
Suite 70 90
Woodstock, GA 30188-4409
13190 Hwy 92
Suite 70 90
Woodstock, GA 30188-4415
Phone (770) 926-9495
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301007348 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sam Chan PC | Chiropractor | Past | Accepting new patients |
| Woodpark Family Chiropractic LLC | Chiropractor | Past | Accepting new patients |
| Lawrence a Gralewski | Chiropractor | Past | Accepting new patients |
| Chiromed Center, Inc | Chiropractor | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Physical Medicine & Rehabilitation Physician
- Woodstock, GA
- NPI 1003180563
-
dba Foothills Chiropractic & Rehab
- Chiropractor
- Woodstock, GA
- NPI 1295032175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1275562175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 DUAL HALL CT",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301276970",
"telephone_number": "770-419-1028",
"fax_number": "770-419-1447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 GOLD CREEK TRL",
"address_2": "STE 100",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301885403",
"telephone_number": "770-926-9495",
"fax_number": "770-926-9284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABOUHAIF",
"first_name": "KHALED",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-02",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301007348",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR008019",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CHOICES",
"identifier": "133505",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "350045598",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS HEALTHPLAN",
"identifier": "4400101",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPLUS",
"identifier": "0980481",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5183617",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLNESS",
"identifier": "1016842-0001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPOM",
"identifier": "383374689",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCLAREN HEALTH",
"identifier": "1002612",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "KA007348",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3334395",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.