Christopher Connelly, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0005997 Issued in GA

Practice address

2045 Rockbridge Rd
Ste 101
Stone Mountain, GA 30087-3551

Phone

(770) 469-7330

Fax

(770) 469-9588

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Village Chiropractic Center

  • Chiropractor
  • Stone Mountain, GA
  • NPI 1093962540
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1508886722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 ROCKBRIDGE RD",
            "address_2": "STE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873551",
            "telephone_number": "770-469-7330",
            "fax_number": "770-469-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 ROCKBRIDGE RD",
            "address_2": "STE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873551",
            "telephone_number": "770-469-7330",
            "fax_number": "770-469-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "0005997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52663882",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350046860",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Connection Bridge Oasis, Inc.
• Carla N Cooke, PA-C
• Carmen Cooper, MA
• Jeniesha Cooper, LPN
• Tanisha Chantal Cooper, PHARMD.
• Della Corbin-Johnson, RPH

• Chiropractor in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.