Organization Active NPI

Mason Mill Chiropractic LLC

  • Chiropractor
  • Decatur, GA
National Provider Identifier
1295445187
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MASON MILL CHIROPRACTIC LLC
Practice address
1275 McConnell Dr Ste E
Decatur, GA 30033-3505
Phone
(404) 321-0082
Fax
(404) 321-2007
NPI assigned
Dec 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Dr. Richard Cohen, D.C.NPI 1467859868
Title
Chiropractor
Phone
(321) 544-9645

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1275 McConnell Dr Ste E
Decatur, GA 30033-3505

Mailing address

1275 McConnell Dr Ste E
Decatur, GA 30033-3505
Phone (404) 321-0082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230118001607 GA Part B Supplier - Clinic/Group Practice 0547631145 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, GA

National Provider Directory

National Provider Directory

Locations

1275 McConnell Dr
Ste E
Decatur, GA 30033
Phone (404) 321-0080

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1295445187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 MCCONNELL DR STE E",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333505",
            "telephone_number": "404-321-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 MCCONNELL DR STE E",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333505",
            "telephone_number": "404-321-0082",
            "fax_number": "404-321-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON MILL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "321-544-9645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 Dec 1, 2022; 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.