Active NPI
Clyde Emir Navarro, D.C.
- Rehabilitation Chiropractor
- Carrollton, GA
National Provider Identifier
1598833634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- CHIR008718
- Practice address
- 775 S Park St
Suite 102
Carrollton, GA 30117-3825 - Phone
- (678) 485-3155
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 380 | PR | |
| Rehabilitation Chiropractor | 111NR0400X | CHIR008718 | GA | Primary |
| Pediatric Chiropractor | 111NP0017X | CHIR008718 | GA |
Addresses
Primary practice location
775 S Park St
Suite 102
Carrollton, GA 30117-3825
Mailing address
775 S Park St
Suite 102
Carrollton, GA 30117-3825
Phone (678) 485-3155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
775 S Park St
Suite 102
Carrollton, GA 30117-3813
Phone (770) 832-1640
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR008718 | GA | MD | Rehabilitation Chiropractor |
Organizations & group practices 1
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.
-
- Rehabilitation Chiropractor
- Carrollton, GA
- NPI 1083057434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366156800000",
"number": "1598833634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "775 S PARK ST",
"address_2": "SUITE 102",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301173825",
"telephone_number": "678-485-3155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 S PARK ST",
"address_2": "SUITE 102",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301173825",
"telephone_number": "678-485-3155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAVARRO",
"first_name": "CLYDE",
"middle_name": "EMIR",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2013-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PR",
"license": "380",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "GA",
"license": "CHIR008718",
"primary": true
},
{
"code": "111NP0017X",
"taxonomy_group": "",
"desc": "Chiropractor, Pediatric Chiropractor",
"state": "GA",
"license": "CHIR008718",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carrollton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.