Individual provider Active NPI

Gavin William Richards, D.C

  • Chiropractor
  • Johns Creek, GA
National Provider Identifier
1477820041
Registry record updated Nov 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO08880 Issued in GA
Practice address
9950 Jones Bridge Rd
Johns Creek, GA 30022-6574
Phone
(770) 754-0037
Fax
(770) 754-7828
NPI assigned
Nov 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO08880 GA Primary

Addresses

Primary practice location

9950 Jones Bridge Rd
Johns Creek, GA 30022-6574

Mailing address

9950 Jones Bridge Rd
Johns Creek, GA 30022-6574
Phone (770) 754-0037

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120127000830 GA Practitioner - Chiropractic 4284891599 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5755 N Point Pkwy
Suite 4
Alpharetta, GA 30022-1136
Phone (770) 754-0037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO08880GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Life Chiropractic L.L.C Chiropractor CurrentSince Apr 16, 2016 Accepting new patients
Levinson Family Chiropractic Chiropractor CurrentSince Jan 1, 2012 Accepting new patients

Locations

5755 N Point Pkwy
Ste 4
Alpharetta, GA 30022
Phone (678) 283-4955

9950 Jones Bridge Rd
Ste 600
Johns Creek, GA 30022
Phone (770) 734-0037

9950 Jones Bridge Rd
Johns Creek, GA 30022
Phone (770) 754-0037

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": "1322179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322179200000",
    "number": "1477820041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9950 JONES BRIDGE RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300226574",
            "telephone_number": "770-754-0037",
            "fax_number": "770-754-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9950 JONES BRIDGE RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300226574",
            "telephone_number": "770-754-0037",
            "fax_number": "770-754-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "GAVIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-25",
        "last_updated": "2011-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO08880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2011; 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.