Shelli Douglas, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR010642 Issued in GA

Practice address

508 Riverside Pkwy NE Ste 300
Rome, GA 30161-2985

Phone

(404) 904-5096

NPI assigned

Oct 25, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Chiropractic Solutions of Georgia, LLC

  • Clinic/Center
  • Rome, GA
  • NPI 1801522743

  GA

  Medicare reassignment NPD Authorized official
• Whitehall Wellness Center

  • Chiropractor
  • Rome, GA
  • NPI 1609070788
  Medicare reassignment NPD

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1306500533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DEVONSHIRE DR SE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614062",
            "telephone_number": "404-904-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 RIVERSIDE PKWY NE STE 300",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301612985",
            "telephone_number": "404-904-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SHELLI",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Benjamin Donner, MD
• Lori Dotson Keith
• Alison Rose Douglas, APRN, ACNPC-AG
• Christopher Michael Popham Douglas, LDO
• James T Douglas, MD
• Christina Douglass, M.D.
• Laura M. Dovan, M.D.
• Justin Dover, DO
• Regina M Dowdy, CNM
• Eamon O Dowling, LCSW

• All providers in Rome, GA
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.