Organization Active NPI

Empower Sports Chiropractic LLC

  • Sports Physician Chiropractor
  • Cumming, GA
National Provider Identifier
1538989587
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
EMPOWER SPORTS CHIROPRACTIC LLC
Practice address
308 Canton Rd Ste B
Cumming, GA 30040-2215
Phone
(706) 994-4618
NPI assigned
Oct 15, 2024
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Jared Croskey, DCNPI 1174288450
Title
Owner
Phone
(706) 994-4618

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X NU Primary

Addresses

Primary practice location

308 Canton Rd Ste B
Cumming, GA 30040-2215

Mailing address

1142 Old Roswell Rd
Roswell, GA 30076-1629
Phone (706) 994-4618

Other practice location 1

12640 Crabapple Rd Ste 120
Alpharetta, GA 30004-4645
Phone (706) 994-4618

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250109002936 GA Part B Supplier - Clinic/Group Practice 1658809231 Practice locations: Cumming, GA

National Provider Directory

National Provider Directory

Locations

12640 Crabapple Rd
Ste 120
Alpharetta, GA 30004
Phone (706) 994-4618

308 Canton Rd
Ste B
Cumming, GA 30040
Phone (407) 281-9796

407 E Maple St
Ste 107
Cumming, GA 30040
Phone (407) 281-9796

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1538989587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 OLD ROSWELL RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761629",
            "telephone_number": "706-994-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 CANTON RD STE B",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402215",
            "telephone_number": "706-994-4618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12640 Crabapple Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300044645",
            "country_code": "US",
            "telephone_number": "706-994-4618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMPOWER SPORTS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "CROSKEY",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-994-4618",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.