Individual provider Active NPI

Jacob Niergarth

  • Chiropractor
  • Evans, GA
National Provider Identifier
1487370078
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO10657 Issued in GA
Practice address
807 Oakhurst Dr Ste a
Evans, GA 30809-3713
Phone
(706) 305-9046
NPI assigned
Oct 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO10657 GA Primary

Addresses

Primary practice location

807 Oakhurst Dr Ste a
Evans, GA 30809-3713

Mailing address

807 Oakhurst Dr Ste a
Evans, GA 30809-3713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231014000517 MI Practitioner - Chiropractic 0345695144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Recovered ChiropracticGroup PAC ID 9638500804, 3 clinicians

Practice addresses (Care Compare)

5601 Highland Rd
Waterford, MI 48327-1927
Phone (248) 618-3467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO10657GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Recovered Chiropractic CurrentSince Oct 1, 2023 Accepting new patients
Evans Injury Chiropractic LLC CurrentSince Oct 16, 2022 Accepting new patients
Michigan Chiropractic Specialists of Waterford, P.C. Chiropractor PastSince Feb 3, 2006 Accepting new patients

Locations

807 Oakhurst Dr
Ste A
Evans, GA 30809
Phone (706) 305-9046

5140 Highland Rd
Ste 1912
Waterford, MI 48327

5601 Highland Rd
Waterford, MI 48327
Phone (248) 618-3467

5140 Highland Rd
Waterford, MI 48327
Phone (248) 618-3467

Organizations & group practices 3

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": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1487370078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 OAKHURST DR STE A",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 OAKHURST DR STE A",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093713",
            "telephone_number": "706-305-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERGARTH",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO10657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.