NPIMap

Organization Active NPI

Fuller Life Chiropractic Center

  • Chiropractor
  • Thomaston, GA
National Provider Identifier
1356487367
Registry record updated Jan 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FULLER LIFE CHIROPRACTIC CENTER
Practice address
1619 Hwy 19 North
Thomaston, GA 30286
Phone
(678) 432-4755
Fax
(678) 432-4753
NPI assigned
Jan 29, 2007
Organization subpart
Yes
Parent organization
FULLERLIFE CHIROPRACTIC CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2013

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

Authorized official

Name
Ronald Fuller, DC
Title
President
Phone
(678) 432-4755

Specialties & licenses 1

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

Addresses

Primary practice location

1619 Hwy 19 North
Thomaston, GA 30286

Mailing address

PO Box 307
Manchester, GA 31816
Phone (678) 432-4755

National Provider Directory

National Provider Directory
Tax ID family
Fuller Life Chiro5 organizations share this tax ID, including this one
Part of
Fuller Life Chiro

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358035200000",
    "number": "1356487367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "MANCHESTER",
            "state": "GA",
            "postal_code": "31816",
            "telephone_number": "678-432-4755",
            "fax_number": "678-432-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 HWY 19 NORTH",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "30286",
            "telephone_number": "678-432-4755",
            "fax_number": "678-432-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER LIFE CHIROPRACTIC CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FULLERLIFE CHIROPRACTIC CENTER",
        "enumeration_date": "2007-01-29",
        "last_updated": "2013-01-13",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-432-4755",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomaston, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.