Organization Active NPI

Elberton Family Chiropractic

  • Chiropractor
  • Elberton, GA
National Provider Identifier
1285991067
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO006573 Issued in GA
Legal business name
ELBERTON FAMILY CHIROPRACTIC
Practice address
14 Laurel Dr
Elberton, GA 30635-1818
Phone
(706) 213-7246
Fax
(888) 214-7136
NPI assigned
Apr 18, 2012
Last updated
Apr 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Authorized official

Name
Dr. Carl Mankiewicz, DCNPI 1588745707
Title
Owner
Phone
(706) 255-0347

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO006573 GA Primary

Addresses

Primary practice location

14 Laurel Dr
Elberton, GA 30635-1818

Mailing address

14 Laurel Dr
Elberton, GA 30635-1818
Phone (706) 213-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120625000495 GA Part B Supplier - Clinic/Group Practice 6901061902 Receives reassigned benefits from 1 practitioner
Practice locations: Elberton, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2289079Elberton Family Chiropractic14 Laurel Drive, Elberton, GA 30635Certificate of waiverSep 5, 2027

National Provider Directory

National Provider Directory

Locations

14 Laurel Dr
Elberton, GA 30635
Phone (706) 213-7246

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1285991067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LAUREL DR",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306351818",
            "telephone_number": "706-213-7246",
            "fax_number": "888-214-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 LAUREL DR",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306351818",
            "telephone_number": "706-213-7246",
            "fax_number": "888-214-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELBERTON FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "MANKIEWICZ",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-255-0347",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO006573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elberton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.