Individual provider Active NPI

Carl Franklin Sircy, D.C.

  • Chiropractor
  • Moultrie, GA
National Provider Identifier
1578751665
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005944 Issued in GA
Practice address
720 S Main St
Moultrie, GA 31768-5450
Phone
(229) 985-1370
NPI assigned
Oct 15, 2007
Last updated
Feb 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 005944 GA Primary

Addresses

Primary practice location

720 S Main St
Moultrie, GA 31768-5450

Mailing address

720 S. Main St.
Moultrie, GA 31768
Phone (229) 985-1370

Other identifiers 1

IdentifierTypeStateIssuer
000958944AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100210000064 GA Practitioner - Chiropractic 7911040134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

714 S Main St
Moultrie, GA 31768-5433
Phone (229) 985-1370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005944GAMDChiropractor
5944GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Clinic of Chiropractic Medicine Chiropractor CurrentSince Jan 4, 1999 Accepting new patients
Arrowhead Clinic, Inc. Chiropractor Past Accepting new patients
Athens Chiropractic & Therapy Chiropractor Past Accepting new patients

Locations

714 S Main St
Moultrie, GA 31768
Phone (229) 985-1270

720 S Main St
Moultrie, GA 31768
Phone (229) 985-1370

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, 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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1578751665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S. MAIN ST.",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "31768",
            "telephone_number": "229-985-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S MAIN ST",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317685450",
            "telephone_number": "229-985-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRCY",
        "first_name": "CARL",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "005944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000958944A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.