NPIMap

Organization Active NPI

DCLC Two PC

  • Chiropractor
  • Dahlonega, GA
National Provider Identifier
1629264072
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
07276 Issued in GA
Legal business name
DCLC TWO PC
Practice address
131 Mechanic St
Dahlonega, GA 30533-1337
Phone
(706) 864-5362
Fax
(706) 864-5761
NPI assigned
Sep 19, 2007
Last updated
Mar 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Curtis FedorchukNPI 1417057050
Title
Provider
Phone
(706) 864-5362

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
Chiropractor 111N00000X 07276 GA Primary

Addresses

Primary practice location

131 Mechanic St
Dahlonega, GA 30533-1337

Mailing address

PO Box 599
Dahlonega, GA 30533-0010
Phone (706) 864-5362

Other identifiers 3

IdentifierTypeStateIssuer
389233OtherGABCBS
DF0709OtherGAMEDICARE RAILROAD
GRP6904OtherGAMEDICARE

National Provider Directory

National Provider Directory

Locations

131 Mechanic St
Dahlonega, GA 30533
Phone (706) 864-5362

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1629264072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 599",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305330010",
            "telephone_number": "706-864-5362",
            "fax_number": "706-864-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MECHANIC ST",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305331337",
            "telephone_number": "706-864-5362",
            "fax_number": "706-864-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DCLC TWO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "FEDORCHUK",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "706-864-5362"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "07276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "389233",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DF0709",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GRP6904",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.