Organization Active NPI

Dr. Michelle Oz LLC D/B/a Momentum Chiropractic

  • Chiropractor
  • Kennesaw, GA
National Provider Identifier
1619483328
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009753 Issued in GA
Legal business name
DR. MICHELLE OZ LLC D/B/A MOMENTUM CHIROPRACTIC
Practice address
3900 Legacy Park Blvd NW
Kennesaw, GA 30144-7412
Phone
(470) 308-3754
NPI assigned
Dec 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Dr. Michelle Lynn Oz, DCNPI 1528515525
Title
Doctor of Chiropractic
Phone
(470) 308-3754

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR009753 GA Primary

Addresses

Primary practice location

3900 Legacy Park Blvd NW
Kennesaw, GA 30144-7412

Mailing address

3900 Legacy Park Blvd NW
Kennesaw, GA 30144-7412

Other identifiers 2

IdentifierTypeStateIssuer
CHIR009753OtherGALICENSE
1528515525OtherGANPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180619002423 GA Part B Supplier - Clinic/Group Practice 6608121488 Receives reassigned benefits from 1 practitioner
Practice locations: Kennesaw, GA

National Provider Directory

National Provider Directory

Locations

1690 Stone Village Ln NW
Ste 702
Kennesaw, GA 30152
Phone (470) 308-3754

3900 Legacy Park Blvd NW
Kennesaw, GA 30144
Phone (404) 482-1943

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1619483328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 LEGACY PARK BLVD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 LEGACY PARK BLVD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447412",
            "telephone_number": "470-308-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICHELLE OZ LLC D/B/A MOMENTUM CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-18",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "OZ",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "470-308-3754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CHIR009753",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1528515525",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.