Organization Active NPI

Synergy Release Sports LLC

  • Chiropractor
  • Alpharetta, GA
National Provider Identifier
1528368909
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR0002950 Issued in GA
Legal business name
SYNERGY RELEASE SPORTS LLC
Practice address
6495 Shiloh Rd Ste A2-110
Alpharetta, GA 30005-1635
Phone
(770) 740-9200
Fax
(770) 752-5607
NPI assigned
Nov 1, 2010
Last updated
Nov 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Authorized official

Name
Michael Hatrak, DCNPI 1194802942
Title
Owner
Phone
(770) 740-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR0002950 GA Primary

Addresses

Primary practice location

6495 Shiloh Rd Ste A2-110
Alpharetta, GA 30005-1635

Mailing address

6495 Shiloh Rd Ste A2-110
Alpharetta, GA 30005-1635
Phone (770) 740-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110222000132 GA Part B Supplier - Clinic/Group Practice 1557542750 Receives reassigned benefits from 5 practitioners
Practice locations: Alpharetta, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1528368909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6495 SHILOH RD STE A2-110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051635",
            "telephone_number": "770-740-9200",
            "fax_number": "770-752-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6495 SHILOH RD STE A2-110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051635",
            "telephone_number": "770-740-9200",
            "fax_number": "770-752-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY RELEASE SPORTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "HATRAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-740-9200",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR0002950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.