Georgia Mountains Wellness Center, PC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CHIR002262 Issued in GA

Legal business name

GEORGIA MOUNTAINS WELLNESS CENTER, PC

Practice address

92 Betty's Creek Road
Dillard, GA 30537

Phone

(706) 782-7878

Fax

(706) 746-5643

NPI assigned

Aug 13, 2009

Last updated

Dec 9, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Allen Bloomingdale, DCNPI 1053493999

Title

Chiropractor/Owner

Phone

(706) 491-2239

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Allen Bloomingdale, D.C.

  • Sports Physician Chiropractor
  • Dillard, GA
  • NPI 1053493999
  NPD (past) Authorized official

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1487886263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305771433",
            "telephone_number": "706-782-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BETTY'S CREEK ROAD",
            "city": "DILLARD",
            "state": "GA",
            "postal_code": "30537",
            "telephone_number": "706-782-7878",
            "fax_number": "706-746-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MOUNTAINS WELLNESS CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-13",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "BLOOMINGDALE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "706-491-2239",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR002262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Allen Bloomingdale, D.C.
• Lauren Harris Brown, LAT, ATC
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• Raymond Gyselinck Jr, DDS
• Health First (Mountain Valley Medical Center)
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• Charlotte Jessandra Jones, DC
• Mason Sawyer DMD LLC (Foothills Dentistry)

• Sports Physician Chiropractor in Dillard, GA
• Providers in Dillard, GA by specialty
• Sports Physician Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.