Individual provider Active NPI

Douglas Lightstone, D.C.

  • Chiropractor
  • Cumming, GA
National Provider Identifier
1295195022
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009649 Issued in GA
Practice address
425 Peachtree Pkwy Ste 315
Cumming, GA 30041-7237
Phone
(770) 573-2777
Fax
(770) 888-1276
NPI assigned
Mar 7, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009649 GA Primary

Addresses

Primary practice location

425 Peachtree Pkwy Ste 315
Cumming, GA 30041-7237

Mailing address

120 Fernwood CT
Alpharetta, GA 30004-5671
Phone (678) 332-7994

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180921002089 GA Practitioner - Chiropractic 4880945369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHBD LLCGroup PAC ID 0941550701, 2 clinicians

Practice addresses (Care Compare)

460 Brannon Rd
Suite 101
Cumming, GA 30041-7551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009649GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
BHBD LLC Chiropractor CurrentSince Jul 31, 2018 Accepting new patients

Locations

425 Peachtree Pkwy
Ste 315
Cumming, GA 30041
Phone (770) 572-2777

460 Brannon Rd
Ste 101
Cumming, GA 30041
Phone (770) 573-2777

Organizations & group practices 1

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": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1295195022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 FERNWOOD CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300045671",
            "telephone_number": "678-332-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PEACHTREE PKWY STE 315",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417237",
            "telephone_number": "770-573-2777",
            "fax_number": "770-888-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTSTONE",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.