Individual provider Active NPI

Maria J Leyva, D.C.

  • Chiropractor
  • Norcross, GA
National Provider Identifier
1619205705
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005705 Issued in GA
Practice address
1568 Indian Trail Lilburn Rd
Suite 105
Norcross, GA 30093-2613
Phone
(770) 696-2404
Fax
(770) 696-2135
NPI assigned
Dec 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR005705 GA Primary

Addresses

Primary practice location

1568 Indian Trail Lilburn Rd
Suite 105
Norcross, GA 30093-2613

Mailing address

1568 Indian Trail Lilburn Rd
Suite 105
Norcross, GA 30093-2613
Phone (770) 696-2404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902000607 GA Practitioner - Chiropractic 9436273067 Practice locations: Loganville, GA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5705GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Three Fold Chiropractic & Wellness Center PC Chiropractor CurrentSince Apr 25, 2020 Accepting new patients
Maxliving Norcross LLC Chiropractor Past Accepting new patients
Injury and Rehab Centers of Georgia, LLC Chiropractor Past Accepting new patients

Locations

120 Camp St
Ste A
Loganville, GA 30052
Phone (770) 466-3344

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1619205705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 INDIAN TRAIL LILBURN RD",
            "address_2": "SUITE 105",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932613",
            "telephone_number": "770-696-2404",
            "fax_number": "770-696-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 INDIAN TRAIL LILBURN RD",
            "address_2": "SUITE 105",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932613",
            "telephone_number": "770-696-2404",
            "fax_number": "770-696-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYVA",
        "first_name": "MARIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.