Individual provider Active NPI

Tina Sills, D.C.

  • Chiropractor
  • College Park, GA
National Provider Identifier
1356560536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
5640 Old National Hwy
College Park, GA 30349-3834
Phone
(404) 768-8008
Fax
(404) 768-9303
NPI assigned
Apr 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X GA Primary

Addresses

Primary practice location

5640 Old National Hwy
College Park, GA 30349-3834

Mailing address

320 Elderberry TRL
Fayetteville, GA 30214-7823
Phone (770) 461-8733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041203000504 GA Practitioner - Chiropractic 8921064767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2003
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

190 Handley Rd
Suite B
Tyrone, GA 30290-2178
Phone (404) 768-8008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044248363GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Humber-Kirk Chiropractic Clinic, LLC Chiropractor CurrentSince Oct 18, 2006 Accepting new patients
Humber-Kirk Chiropractic Clinic, LLC Chiropractor Current Accepting new patients

Locations

820 Ebenezer Church Rd
Ste 100
Sharpsburg, GA 30277
Phone (770) 251-4345

190 Handley Rd
Ste B
Tyrone, GA 30290
Phone (404) 768-8008

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356560536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ELDERBERRY TRL",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147823",
            "telephone_number": "770-461-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 OLD NATIONAL HWY",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493834",
            "telephone_number": "404-768-8008",
            "fax_number": "404-768-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLS",
        "first_name": "TINA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.