Individual provider Active NPI

Jesus Emmanuel Andino Rodriguez, DC

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1548086135
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CIR011229 Issued in GA
Practice address
5010 Paces Station Dr Unit 1
Atlanta, GA 30339-4055
Phone
(787) 215-6009
NPI assigned
Nov 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CIR011229 GA Primary

Addresses

Primary practice location

5010 Paces Station Dr Unit 1
Atlanta, GA 30339-4055

Mailing address

5010 Paces Station Dr Unit 1
Atlanta, GA 30339-4055
Phone (787) 215-6009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250506002958 FL Practitioner - Chiropractic 3375060072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midtown Chiropractic LLCGroup PAC ID 3577782820, 6 clinicians

Practice addresses (Care Compare)

3208 Lantana Rd
Lantana, FL 33462-2432
Phone (561) 533-3884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CIR011229GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Chiropractic PLLC Chiropractor CurrentSince Mar 2, 2025 Accepting new patients
Midtown Chiropractic LLC Chiropractor Past Accepting new patients

Locations

3208 Lantana Rd
Lantana, FL 33462
Phone (561) 439-7349

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1548086135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 PACES STATION DR UNIT 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394055",
            "telephone_number": "787-215-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 PACES STATION DR UNIT 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394055",
            "telephone_number": "787-215-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDINO RODRIGUEZ",
        "first_name": "JESUS",
        "middle_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CIR011229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.