Individual provider Active NPI

David Lee Winfrey, D.C.

  • Chiropractor
  • Fayetteville, GA
National Provider Identifier
1366715039
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO008920 Issued in GA
Practice address
745 Glynn St S
Fayetteville, GA 30214-2049
Phone
(770) 599-1010
Fax
(770) 947-8973
NPI assigned
Feb 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO008920 GA Primary

Addresses

Primary practice location

745 Glynn St S
Fayetteville, GA 30214-2049

Mailing address

PO Box 142705
Fayetteville, GA 30214-6519
Phone (770) 599-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120730000401 GA Practitioner - Chiropractic 5799941134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

745 Glynn S St
Fayetteville, GA 30214-2049
Phone (770) 599-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO008920GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthquest Chiropractic of Georgia Chiropractor CurrentSince Jun 10, 2012 Accepting new patients

Locations

745 Glynn St S
Fayetteville, GA 30214
Phone (770) 599-1010

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1366715039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 142705",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302146519",
            "telephone_number": "770-599-1010",
            "fax_number": "770-947-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 GLYNN ST S",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142049",
            "telephone_number": "770-599-1010",
            "fax_number": "770-947-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINFREY",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-10",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO008920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.