Active NPI
Joquan Charleswell, DC
- Chiropractor
- Ellenwood, GA
National Provider Identifier
1306661475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIRO11238
- Practice address
- 5498 Frontier CT
Ellenwood, GA 30294-4386 - Phone
- (678) 879-7575
- NPI assigned
- Nov 22, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIRO11238 | GA | Primary |
Addresses
Primary practice location
5498 Frontier CT
Ellenwood, GA 30294-4386
Mailing address
5498 Frontier CT
Ellenwood, GA 30294-4386
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIRO11238 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1306661475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5498 FRONTIER CT",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302944386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5498 FRONTIER CT",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302944386",
"telephone_number": "678-879-7575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLESWELL",
"first_name": "JOQUAN",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-22",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIRO11238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellenwood, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.