Individual provider Active NPI

Justin Jenkins, DC

  • Chiropractor
  • Kennesaw, GA
National Provider Identifier
1356209738
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR066622 Issued in GA
Practice address
2680 Cobb Pkwy NW Ste C
Kennesaw, GA 30152-3470
Phone
(770) 343-4128
NPI assigned
Jan 13, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR066622 GA Primary

Addresses

Primary practice location

2680 Cobb Pkwy NW Ste C
Kennesaw, GA 30152-3470

Mailing address

201 Hospital Rd Unit 4014
Canton, GA 30114-2642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260521003871 GA Practitioner - Chiropractic 9638649478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

201 Hospital Rd
Unit 4014
Canton, GA 30114-2408

2680 Cobb Pkwy NW
Suite C
Kennesaw, GA 30152-3470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR066622GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
True Flow Chiropractic Chiropractor Current Accepting new patients
Backsmith LLC Chiropractor PastSince Sep 1, 2023 Accepting new patients

Locations

2680 Cobb Pkwy NW
Ste C
Kennesaw, GA 30152
Phone (770) 343-4128

Organizations & group practices 2

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": "1768262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1356209738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HOSPITAL RD UNIT 4014",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 COBB PKWY NW STE C",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523470",
            "telephone_number": "770-343-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JUSTIN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR066622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.