Individual provider Active NPI

Hyung Pak, D.C.

  • Chiropractor
  • Jonesboro, GA
National Provider Identifier
1336326305
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007891 Issued in GA
Practice address
2244 Mount Zion Rd
Jonesboro, GA 30236-2528
Phone
(678) 610-7587
Fax
(678) 610-4047
NPI assigned
Jan 22, 2008
Last updated
Sep 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR007891 GA Primary

Addresses

Primary practice location

2244 Mount Zion Rd
Jonesboro, GA 30236-2528

Mailing address

2244 Mount Zion Rd
Jonesboro, GA 30236-2528
Phone (678) 610-7587

Other practice location 1

2010 Mount Zion Rd
Suite C
Morrow, GA 30260-3314
Phone (678) 610-7587

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140227000060 GA Practitioner - Chiropractic 3375773963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2244 Mount Zion Rd
Jonesboro, GA 30236-2528
Phone (678) 610-7587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR007891GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Plus, LLC Chiropractor CurrentSince Sep 15, 2013 Accepting new patients

Locations

2244 Mount Zion Rd
Jonesboro, GA 30236
Phone (678) 610-7587

2010 Mount Zion Rd
Ste C
Morrow, GA 30260
Phone (678) 610-7581

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": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1336326305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2244 MOUNT ZION RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362528",
            "telephone_number": "678-610-7587",
            "fax_number": "678-610-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2244 MOUNT ZION RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362528",
            "telephone_number": "678-610-7587",
            "fax_number": "678-610-4047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 Mount Zion Rd",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Morrow",
            "state": "GA",
            "postal_code": "302603314",
            "country_code": "US",
            "telephone_number": "678-610-7587",
            "fax_number": "678-610-4047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAK",
        "first_name": "HYUNG",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-22",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.