Individual provider Active NPI

Monica Mallamace

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1295557189
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010428 Issued in GA
Practice address
12045 Highway 92
Woodstock, GA 30188-4499
Phone
(678) 848-5121
NPI assigned
Oct 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010428 GA Primary

Addresses

Primary practice location

12045 Highway 92
Woodstock, GA 30188-4499

Mailing address

12045 Highway 92
Woodstock, GA 30188-4499
Phone (678) 848-5121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250304000267 GA Practitioner - Chiropractic 7012438344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Alliance Spine and Physical MedicineGroup PAC ID 9638604630, 4 clinicians

Practice addresses (Care Compare)

12045 Hwy 92
Woodstock, GA 30188-4499
Phone (678) 469-6939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR010428GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Spine and Physical Medicine Chiropractor CurrentSince Jan 15, 2025 Accepting new patients

Locations

12045 Highway 92
Woodstock, GA 30188
Phone (404) 644-9615

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": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1295557189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12045 HIGHWAY 92",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884499",
            "telephone_number": "678-848-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12045 HIGHWAY 92",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884499",
            "telephone_number": "678-848-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAMACE",
        "first_name": "MONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.