Individual provider Active NPI

Jeffrey Lance Lubow

  • Chiropractor
  • Alpharetta, GA
National Provider Identifier
1619046083
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR006837 Issued in GA
Practice address
380 N Main St
Alpharetta, GA 30009-2322
Phone
(678) 566-3030
Fax
(678) 566-3035
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 7693 FL
Chiropractor 111N00000X CHIR006837 GA Primary

Addresses

Primary practice location

380 N Main St
Alpharetta, GA 30009-2322

Mailing address

380 N Main St
Alpharetta, GA 30009-2322
Phone (678) 566-3030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114000264 GA Practitioner - Chiropractic 1759666340 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 7693FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Windward Healthcare Center LLC Chiropractor CurrentSince Aug 15, 2012 Accepting new patients

Locations

3225 North Point Pkwy
Ste 101
Alpharetta, GA 30005
Phone (678) 566-3030

2905 Jordan Ct
Ste F
Alpharetta, GA 30004
Phone (678) 566-3030

380 N Main St
Alpharetta, GA 30009
Phone (678) 566-3030

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10801/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1619046083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 N MAIN ST",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092322",
            "telephone_number": "678-566-3030",
            "fax_number": "678-566-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 N MAIN ST",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092322",
            "telephone_number": "678-566-3030",
            "fax_number": "678-566-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBOW",
        "first_name": "JEFFREY",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7693",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.