Individual provider Active NPI

Justin Utley, D.C.

  • Chiropractor
  • Stone Mountain, GA
National Provider Identifier
1548667249
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009423 Issued in GA
Practice address
813 Main St
Stone Mountain, GA 30083-3620
Phone
(404) 292-2492
NPI assigned
Nov 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009423 GA Primary

Addresses

Primary practice location

813 Main St
Stone Mountain, GA 30083-3620

Mailing address

813 Main St
Stone Mountain, GA 30083-3620
Phone (404) 292-2492

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250421002074 GA Practitioner - Chiropractic 3173047156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

813 Main St
Stone Mountain, GA 30083-3620
Phone (404) 292-2492

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009423GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Utley Chiropractic Inc Chiropractor CurrentSince Mar 18, 2025 Accepting new patients
Well Beings Pain Relief & Peak Performance Center, LLC Chiropractor Past Accepting new patients

Locations

813 Main St
Stone Mountain, GA 30083
Phone (404) 292-2492

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1548667249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 MAIN ST",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833620",
            "telephone_number": "404-292-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 MAIN ST",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833620",
            "telephone_number": "404-292-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTLEY",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2025-03-18",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.