Individual provider Active NPI

Sherra Bryant Conde, D.C.

  • Chiropractor
  • Peachtree City, GA
National Provider Identifier
1598097172
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011621 Issued in IL
Practice address
40 Eastbrook BND
Peachtree City, GA 30269-1567
Phone
(305) 834-9839
NPI assigned
Feb 5, 2010
Last updated
Oct 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011621 IL Primary

Addresses

Primary practice location

40 Eastbrook BND
Peachtree City, GA 30269-1567

Mailing address

PO Box 719
Manchester, GA 31816-0719
Phone (706) 846-2787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121008000320 GA Practitioner - Chiropractic 7214069087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

140 Carnegie PL
Suite 106
Fayetteville, GA 30214-7911
Phone (404) 455-3654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038011621ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spinealign PC Chiropractor CurrentSince Nov 7, 2023 Accepting new patients
Mitchell Family Chiropractic PC Chiropractor Past Accepting new patients
Fuller Life Solutions Chiropractor Past Accepting new patients

Locations

140 Carnegie Pl
Ste 106
Fayetteville, GA 30214
Phone (404) 455-3654

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": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1598097172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "MANCHESTER",
            "state": "GA",
            "postal_code": "318160719",
            "telephone_number": "706-846-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EASTBROOK BND",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691567",
            "telephone_number": "305-834-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDE",
        "first_name": "SHERRA",
        "middle_name": "BRYANT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.