Samantha Michelle Gillingham, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIRO11044 Issued in GA

Practice address

1240 Highway 54 W Ste 503
Fayetteville, GA 30214-4561

Phone

(678) 667-4660

NPI assigned

Jul 12, 2023

Last updated

Jul 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Barclay Chiropractic & Wellness, LLC

  • Chiropractor
  • Fayetteville, GA
  • NPI 1801411459
  NPD

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1497434013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 OAK SPRINGS LN",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301321045",
            "telephone_number": "270-505-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 HIGHWAY 54 W STE 503",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144561",
            "telephone_number": "678-667-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLINGHAM",
        "first_name": "SAMANTHA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO11044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.