Justin Bruce Gibson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR010435 Issued in GA

Practice address

11 Charley Harper Dr Ste 140
Cartersville, GA 30120-0027

Phone

(912) 614-1795

NPI assigned

Oct 15, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• 100 Percent Chiropractic Gibson LLC

  • Chiropractor
  • Cartersville, GA
  • NPI 1043818693
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1336747989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 BELLS FERRY RD NE",
            "city": "WHITE",
            "state": "GA",
            "postal_code": "301842852",
            "telephone_number": "912-614-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CHARLEY HARPER DR STE 140",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301200027",
            "telephone_number": "912-614-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JUSTIN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO10435",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daryl Gessner
• Anastasia Arabella Getz
• Viola H Ghawi, PHARMD
• Sonam Ghimire
• Corey M Gibson, D.P.T
• Willie C Gilbert Jr., DO
• Riaz Qadeer Gill, MD
• Scott D Gillogly, M.D.
• Bradley Gilmore
• Girasoles Counseling LLC

• Chiropractor in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.