Active NPI
Nicole James Wilson, D.C.
- Chiropractor
- Austell, GA
National Provider Identifier
1639848930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIRO09405
- Practice address
- 1736 Brandemere Drive
Austell, GA 30168 - Phone
- (404) 919-9037
- NPI assigned
- Sep 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIRO09405 | GA | Primary |
Addresses
Primary practice location
1736 Brandemere Drive
Austell, GA 30168
Mailing address
1736 Brandemere Dr
Austell, GA 30168-5341
Phone (281) 543-5015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIRO09405 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631145600000",
"number": "1639848930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1736 BRANDEMERE DR",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301685341",
"telephone_number": "281-543-5015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1736 BRANDEMERE DRIVE",
"city": "AUSTELL",
"state": "GA",
"postal_code": "30168",
"telephone_number": "404-919-9037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES WILSON",
"first_name": "NICOLE",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-09",
"last_updated": "2021-09-09",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIRO09405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.