Individual provider Active NPI

John Irvin Brown IV, DC

  • Chiropractor
  • Tucker, GA
National Provider Identifier
1568703239
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009005 Issued in GA
Practice address
2347 Brockett Rd
Tucker, GA 30084-4474
Phone
(770) 938-4606
NPI assigned
Mar 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009005 GA Primary

Addresses

Primary practice location

2347 Brockett Rd
Tucker, GA 30084-4474

Mailing address

2347 Brockett Rd
Tucker, GA 30084-4474
Phone (770) 938-4606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161025002040 NV Practitioner - Chiropractic 1951621143 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009005GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Golan Integrated Physical Medicine Chiropractor CurrentSince Aug 17, 2016 Accepting new patients
Golan Integrated Physical Medicine Chiropractor CurrentSince Aug 17, 2016 Accepting new patients
Complete Spine Solutions, PC Chiropractor PastSince Jun 6, 2019 Accepting new patients

Locations

6592 N Decatur Blvd
Ste 115
Las Vegas, NV 89131
Phone (702) 396-4993

Organizations & group practices 3

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": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1568703239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 BROCKETT RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844474",
            "telephone_number": "770-938-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 BROCKETT RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844474",
            "telephone_number": "770-938-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JOHN",
        "middle_name": "IRVIN",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.