Individual provider Active NPI

Joshua Brett Mizell, D.C.

  • Chiropractor
  • Douglas, GA
National Provider Identifier
1417249343
Registry record updated Aug 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008807 Issued in GA
Practice address
506 Ashley St W
Douglas, GA 31533-2308
Phone
(912) 427-8433
Fax
(912) 427-9851
NPI assigned
May 11, 2011
Last updated
Aug 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR008807 GA Primary

Addresses

Primary practice location

506 Ashley St W
Douglas, GA 31533-2308

Mailing address

506 Ashley St W
Douglas, GA 31533-2308
Phone (912) 427-8433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111031000529 GA Practitioner - Chiropractic 7618140005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

506 Ashley St W
Douglas, GA 31533-2308
Phone (912) 389-0042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008807GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Chiropractic of Douglas, Inc. Chiropractor CurrentSince Dec 14, 2023 Accepting new patients
Advanced Health Care Center PastSince Feb 1, 1996 Accepting new patients

Locations

506 Ashley St W
Douglas, GA 31533
Phone (912) 389-0042

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503705600000",
    "number": "1417249343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ASHLEY ST W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332308",
            "telephone_number": "912-427-8433",
            "fax_number": "912-427-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 ASHLEY ST W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332308",
            "telephone_number": "912-427-8433",
            "fax_number": "912-427-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZELL",
        "first_name": "JOSHUA",
        "middle_name": "BRETT",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2017-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2017; 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.