Individual provider Active NPI

Justin James Broe, D.C.

  • Chiropractor
  • Sandy Springs, GA
National Provider Identifier
1417148198
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009279 Issued in GA
Practice address
5942 Roswell Rd
Sandy Springs, GA 30328-4908
Phone
(404) 252-2520
Fax
(404) 255-6703
NPI assigned
Aug 7, 2007
Last updated
Apr 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009279 GA Primary

Addresses

Primary practice location

5942 Roswell Rd
Sandy Springs, GA 30328-4908

Mailing address

5942 Roswell Rd
Sandy Springs, GA 30328-4908
Phone (404) 252-2520

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140910001232 GA Practitioner - Chiropractic 1951495852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Horizon Health Care Medical Services IncGroup PAC ID 7618196403, 2 clinicians

Practice addresses (Care Compare)

5942 Roswell Rd
Sandy Springs, GA 30328-4908
Phone (404) 252-2520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009279GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health Care Medical Services, Inc Chiropractor CurrentSince Jun 25, 2014 Accepting new patients
Pro Health Chiropractic LLC Chiropractor PastSince Feb 1, 2008 Accepting new patients
Horizon Health Care Medical Services Past Accepting new patients
Skagit River Chiropractic PS Inc Chiropractor PastSince Apr 10, 2000 Accepting new patients

Locations

5942 Roswell Rd
Sandy Springs, GA 30328
Phone (404) 252-2520

Organizations & group practices 4

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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1417148198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5942 ROSWELL RD",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303284908",
            "telephone_number": "404-252-2520",
            "fax_number": "404-255-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5942 ROSWELL RD",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303284908",
            "telephone_number": "404-252-2520",
            "fax_number": "404-255-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROE",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; 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.