Organization Active NPI

Backsmart Health LLC - North Ga Diagnostic & Rehab

Doing business as North GA Diag and Rehab

  • Rehabilitation Chiropractor
  • Alpharetta, GA
National Provider Identifier
1356042055
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
BACKSMART HEALTH LLC - NORTH GA DIAGNOSTIC & REHAB
Doing business as
North GA Diag and Rehab
Practice address
2650 Holcomb Bridge Rd Ste 140
Alpharetta, GA 30022-5335
Phone
(770) 451-9494
NPI assigned
Mar 10, 2023
Last updated
Apr 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BACKSMART HEALTH LLC - NORTH GA DIAGNOSTIC & REHABAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Dr. Gregory KingNPI 1881633055
Title
Owner
Phone
(770) 888-4288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X NU Primary

Addresses

Primary practice location

2650 Holcomb Bridge Rd Ste 140
Alpharetta, GA 30022-5335

Mailing address

2650 Holcomb Bridge Rd Ste 140
Alpharetta, GA 30022-5335
Phone (770) 451-9494

Other names 1

  • North GA Diag and Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110401000506 GA Part B Supplier - Clinic/Group Practice 4789868589 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alpharetta, GA; Cumming, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Backsmart Health LLC

Locations

5485 Bethelview Rd
Ste 360225
Cumming, GA 30040
Phone (770) 888-4288

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1356042055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 HOLCOMB BRIDGE RD STE 140",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300225335",
            "telephone_number": "770-451-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 HOLCOMB BRIDGE RD STE 140",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300225335",
            "telephone_number": "770-451-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACKSMART HEALTH LLC - NORTH GA DIAGNOSTIC & REHAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BACKSMART HEALTH LLC - NORTH GA DIAGNOSTIC & REHAB",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-888-4288",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North GA Diag and Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North GA Diag and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.