Individual provider Active NPI

Cuong Van Tran, D.C

  • Chiropractor
  • Decatur, GA
National Provider Identifier
1285877084
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
008440 Issued in GA
Practice address
4294 Memorial Dr
Suite D
Decatur, GA 30032-1226
Phone
(404) 296-4888
Fax
(404) 296-8811
NPI assigned
Apr 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 008440 GA Primary

Addresses

Primary practice location

4294 Memorial Dr
Suite D
Decatur, GA 30032-1226

Mailing address

4294 Memorial Dr
Suite D
Decatur, GA 30032-1226
Phone (404) 296-4888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121015000008 GA Practitioner - Chiropractic 5991954679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Injury 2 Wellness Centers, PC Chiropractor CurrentSince Apr 22, 2016 Accepting new patients
Performance Injury Center LLC. Chiropractor Past Accepting new patients

Locations

4982 Covington Hwy
Decatur, GA 30035
Phone (404) 288-8433

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": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1285877084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4294 MEMORIAL DR",
            "address_2": "SUITE D",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321226",
            "telephone_number": "404-296-4888",
            "fax_number": "404-296-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4294 MEMORIAL DR",
            "address_2": "SUITE D",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321226",
            "telephone_number": "404-296-4888",
            "fax_number": "404-296-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "CUONG",
        "middle_name": "VAN",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "008440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.