NPIMap

Organization Active NPI

Lighthouse Family Chiropractic, P.C.

  • Chiropractor
  • Douglasville, GA
National Provider Identifier
1407032840
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR006715 Issued in GA
Legal business name
LIGHTHOUSE FAMILY CHIROPRACTIC, P.C.
Practice address
4935 Stewart Mill Rd
Suite 101
Douglasville, GA 30135-6733
Phone
(678) 838-4433
Fax
(678) 838-4093
NPI assigned
Jan 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Dr. Kathryn E Lewis-Padgett, D.C.NPI 1831127703
Title
President
Phone
(678) 838-4433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR006715 GA Primary

Addresses

Primary practice location

4935 Stewart Mill Rd
Suite 101
Douglasville, GA 30135-6733

Mailing address

4935 Stewart Mill Rd
Ste. 101
Douglasville, GA 30135-6733
Phone (678) 838-4433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000689 GA Part B Supplier - Clinic/Group Practice 6800782574 Receives reassigned benefits from 1 practitioner
Practice locations: Douglasville, GA

National Provider Directory

National Provider Directory

Locations

3680 Kings Hwy
Douglasville, GA 30135
Phone (678) 838-4433

4935 Stewart Mill Rd
Ste 101
Douglasville, GA 30135
Phone (678) 838-4433

Practitioners & affiliated clinicians

Practitioners 3

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": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1407032840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4935 STEWART MILL RD",
            "address_2": "STE. 101",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356733",
            "telephone_number": "678-838-4433",
            "fax_number": "678-838-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 STEWART MILL RD",
            "address_2": "SUITE 101",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356733",
            "telephone_number": "678-838-4433",
            "fax_number": "678-838-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE FAMILY CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "LEWIS-PADGETT",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-838-4433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.