Individual provider Active NPI

Kenneth Strack, D.C.

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1497281810
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009881 Issued in GA
Practice address
246 Creekstone RDG
Woodstock, GA 30188-3732
Phone
(678) 494-9668
Fax
(678) 494-9771
NPI assigned
May 4, 2017
Last updated
Jan 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009881 GA Primary

Addresses

Primary practice location

246 Creekstone RDG
Woodstock, GA 30188-3732

Mailing address

246 Creekstone RDG
Woodstock, GA 30188-3732
Phone (678) 494-9668

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190416003211 GA Practitioner - Chiropractic 5991046161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

246 Creekstone RDG
Woodstock, GA 30188-3732
Phone (678) 494-9668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Strack Chiropractic Wellness Center, LLC CurrentSince Jan 19, 2019 Accepting new patients

Locations

246 Creekstone Rdg
Woodstock, GA 30188
Phone (678) 494-9668

Organizations & group practices 1

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": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1497281810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883732",
            "telephone_number": "678-494-9668",
            "fax_number": "678-494-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883732",
            "telephone_number": "678-494-9668",
            "fax_number": "678-494-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRACK",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.