Individual provider Active NPI

Charles A McDill, D.C.

  • Chiropractor
  • Trenton, GA
National Provider Identifier
1275612756
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007560 Issued in GA
Practice address
12551 North Main Street
Trenton, GA 30752-1044
Phone
(706) 657-4777
Fax
(706) 657-2034
NPI assigned
Nov 3, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR007560 GA Primary

Addresses

Primary practice location

12551 North Main Street
Trenton, GA 30752-1044

Mailing address

12551 North Main Street
P.O. Box 1044
Trenton, GA 30752-1044
Phone (706) 657-4777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423001171 GA Practitioner - Chiropractic 9739175738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4580 Hwy 136
Trenton, GA 30752-2909
Phone (706) 657-4777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR007560GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Chiropractic Care, LLC Chiropractor CurrentSince Jan 6, 2004 Accepting new patients
Dade County Chiropractic Center LLC Chiropractor PastSince Oct 22, 2011 Accepting new patients

Locations

12551 N Main St
Trenton, GA 30752
Phone (706) 657-4777

4580 Highway 136
Trenton, GA 30752
Phone (706) 657-4777

2433 Broad St
Chattanooga, TN 37408
Phone (423) 265-2673

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, 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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275612756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12551 NORTH MAIN STREET",
            "address_2": "P.O. BOX 1044",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307521044",
            "telephone_number": "706-657-4777",
            "fax_number": "706-657-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12551 NORTH MAIN STREET",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307521044",
            "telephone_number": "706-657-4777",
            "fax_number": "706-657-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDILL",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.