NPIMap

Organization Active NPI

Towne Lake Family Chiropractic P.C.

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1346379435
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR004770 Issued in GA
Legal business name
TOWNE LAKE FAMILY CHIROPRACTIC P.C.
Practice address
1000 Wyngate Pkwy
Suite 200
Woodstock, GA 30189-6981
Phone
(770) 592-1877
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Authorized official

Name
Kirk Alan Pusey, D.C.
Title
President
Phone
(770) 592-1877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR004770 GA Primary

Addresses

Primary practice location

1000 Wyngate Pkwy
Suite 200
Woodstock, GA 30189-6981

Mailing address

1000 Wyngate Pkwy
Suite 200
Woodstock, GA 30189-6981
Phone (770) 592-1877

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111111000323 GA Part B Supplier - Clinic/Group Practice 1355515222 Receives reassigned benefits from 2 practitioners
Practice locations: Woodstock, GA

National Provider Directory

National Provider Directory
Tax ID family
Towne Lake Family Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1000 Wyngate Pkwy
Ste 200
Woodstock, GA 30189
Phone (770) 592-1877

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1346379435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WYNGATE PKWY",
            "address_2": "SUITE 200",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896981",
            "telephone_number": "770-592-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WYNGATE PKWY",
            "address_2": "SUITE 200",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896981",
            "telephone_number": "770-592-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWNE LAKE FAMILY CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "PUSEY",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-592-1877",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR004770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.