Individual provider Active NPI

Mitchell Shea Arnold, D.C.

  • Rehabilitation Chiropractor
  • Marietta, GA
National Provider Identifier
1407983885
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CHIR006422 Issued in GA
Practice address
3894 Due West Rd NW Ste 210
Marietta, GA 30064-1072
Phone
(678) 285-1100
Fax
(678) 285-1102
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CHIR006422 GA Primary

Addresses

Primary practice location

3894 Due West Rd NW Ste 210
Marietta, GA 30064-1072

Mailing address

3894 Due West Rd NW Ste 210
Marietta, GA 30064-1072
Phone (678) 285-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040702000058 GA Practitioner - Chiropractic 7214914811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3894 Due W Rd NW
Suite 210
Marietta, GA 30064-1072
Phone (678) 285-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A&W Family Chiropractic, Inc CurrentSince Jan 26, 2004 Accepting new patients

Locations

3894 Due West Rd NW
Ste 210
Marietta, GA 30064
Phone (678) 285-1100

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1407983885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3894 DUE WEST RD NW STE 210",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641072",
            "telephone_number": "678-285-1100",
            "fax_number": "678-285-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3894 DUE WEST RD NW STE 210",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641072",
            "telephone_number": "678-285-1100",
            "fax_number": "678-285-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "MITCHELL",
        "middle_name": "SHEA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR006422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.