Organization Active NPI

Holcomb Bridge Chiropractic, PC

  • Chiropractor
  • Roswell, GA
National Provider Identifier
1578681920
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005108 Issued in GA
Legal business name
HOLCOMB BRIDGE CHIROPRACTIC, PC
Practice address
865B Holcomb Bridge Rd
Roswell, GA 30076-1954
Phone
(770) 992-8337
Fax
(770) 518-6373
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Charles G Weiss, DCNPI 1083786107
Title
President
Phone
(770) 992-8337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR005108 GA Primary

Addresses

Primary practice location

865B Holcomb Bridge Rd
Roswell, GA 30076-1954

Mailing address

865B Holcomb Bridge Rd
Roswell, GA 30076-1954

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050428001025 GA Part B Supplier - Clinic/Group Practice 7719926716 Receives reassigned benefits from 1 practitioner
Practice locations: Roswell, GA

National Provider Directory

National Provider Directory

Locations

1020 Woodstock Rd
Ste 2108
Roswell, GA 30075
Phone (770) 992-8337

865 Holcomb Bridge Rd
Ste B
Roswell, GA 30076
Phone (770) 992-8337

Practitioners & affiliated clinicians

Practitioners 3

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": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578681920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865B HOLCOMB BRIDGE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865B HOLCOMB BRIDGE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761954",
            "telephone_number": "770-992-8337",
            "fax_number": "770-518-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLCOMB BRIDGE CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-992-8337",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.