Individual provider Active NPI

Christopher Nicholas Jerry, DC

  • Chiropractor
  • Peachtree Corners, GA
National Provider Identifier
1427722404
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO10574 Issued in GA
Practice address
3949 Holcomb Bridge Rd Ste 201
Peachtree Corners, GA 30092-2208
Phone
(770) 368-0333
NPI assigned
Aug 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO10574 GA Primary

Addresses

Primary practice location

3949 Holcomb Bridge Rd Ste 201
Peachtree Corners, GA 30092-2208

Mailing address

3949 Holcomb Bridge Rd Ste 201
Peachtree Corners, GA 30092-2208
Phone (770) 368-0333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221213000434 GA Practitioner - Chiropractic 0446629547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3949 Holcomb Bridge Rd
Suite 201
Norcross, GA 30092-2208
Phone (770) 368-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO10574GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic Clinic PC Chiropractor CurrentSince Oct 31, 2022 Accepting new patients
Peachtree Corners Chiropractic Plus LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

3232 Krisam Creek Dr
Ste 200
Loganville, GA 30052
Phone (678) 957-6808

3949 Holcomb Bridge Rd
Ste 201
Peachtree Corners, GA 30092
Phone (770) 368-0333

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1427722404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 HOLCOMB BRIDGE RD STE 201",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300922208",
            "telephone_number": "770-368-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 HOLCOMB BRIDGE RD STE 201",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300922208",
            "telephone_number": "770-368-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERRY",
        "first_name": "CHRISTOPHER",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-04",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO10574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Corners, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.