Shayla Italo, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4779 Issued in SC

Practice address

1860 Duluth Hwy
Lawrenceville, GA 30043-5011

Phone

(770) 824-0336

NPI assigned

Feb 8, 2022

Last updated

Feb 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ideal Lifestyle Practice LLC

  • Chiropractor
  • Mount Pleasant, SC
  • NPI 1063832772
  NPD

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1578217527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 MIXSON AVE APT 309",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294053227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 DULUTH HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435011",
            "telephone_number": "770-824-0336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Long Point Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294648328",
            "country_code": "US",
            "telephone_number": "843-352-9966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ITALO",
        "first_name": "SHAYLA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henrietta Chigozie Iroha
• Joy Osarowmeniyeke Iroro, MD
• Iskol & Fisk LLC
• Gary K Iskol, D.D.S.
• Kamarya A. Isom, LAPC
• Itas Herd Ga Corporation (Senior Helpers)
• Itransport Group
• Anita Ituwe
• Dawn Mazie Itzie, PA-C
• Alexandre Ivanov

• Chiropractor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.