Individual provider Active NPI

Masaki Nakamura

  • Chiropractor
  • Snellville, GA
National Provider Identifier
1306711031
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR011140 Issued in GA
Practice address
2386 Clower St
Snellville, GA 30078-6134
Phone
(770) 985-9390
NPI assigned
Oct 10, 2025
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR011140 GA Primary

Addresses

Primary practice location

2386 Clower St
Snellville, GA 30078-6134

Mailing address

2386 Clower St
Snellville, GA 30078-6134
Phone (770) 985-9390

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251209000499 GA Practitioner - Chiropractic 2769976737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1249 Briarvista Way NE
Atlanta, GA 30329-3631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR011140GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
McEwen Chiropractic Center, Inc. Chiropractor CurrentSince Oct 10, 2025 Accepting new patients

Locations

2386 Clower St
Ste G102
Snellville, GA 30078
Phone (770) 985-9390

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1760054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1306711031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786134",
            "telephone_number": "770-985-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786134",
            "telephone_number": "770-985-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "MASAKI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-10",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR011140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.