Individual provider Active NPI

Hayden McCarthy Richardson, DV

  • Chiropractor
  • Decatur, GA
National Provider Identifier
1386239572
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010476 Issued in GA
Practice address
4319 Covington Hwy Ste 201
Decatur, GA 30035-1206
Phone
(678) 505-0000
NPI assigned
Mar 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010476 GA Primary

Addresses

Primary practice location

4319 Covington Hwy Ste 201
Decatur, GA 30035-1206

Mailing address

4319 Covington Hwy Ste 201
Decatur, GA 30035-1206
Phone (678) 505-0000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hrichardson@iceberghealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230117002420 GA Practitioner - Chiropractic 5991176638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Clinic of Ga PCGroup PAC ID 5395122675, 5 clinicians

Practice addresses (Care Compare)

855 N Point Pkwy
Alpharetta, GA 30005-4125
Phone (952) 401-2336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spine , Muscle and Joint Inc CurrentSince Mar 16, 2021 Accepting new patients
Integrated Therapy LLC CurrentSince Dec 3, 2022 Accepting new patients
Life Clinic of Ga PC Chiropractor CurrentSince Dec 3, 2022 Accepting new patients

Locations

855 North Point Pkwy
Alpharetta, GA 30005
Phone (952) 401-2336

4319 Covington Hwy
Ste 201
Decatur, GA 30035
Phone (678) 505-0000

Organizations & group practices 3

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": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1386239572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 COVINGTON HWY STE 201",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300351206",
            "telephone_number": "678-505-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 COVINGTON HWY STE 201",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300351206",
            "telephone_number": "678-505-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "HAYDEN",
        "middle_name": "MCCARTHY",
        "name_prefix": "Dr.",
        "credential": "DV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hrichardson@iceberghealth.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4319 Covington Hwy Ste 201",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300351206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.