Organization Active NPI

Erthal Chiropractic Center

  • Chiropractor
  • Macon, GA
National Provider Identifier
1649509019
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007686 Issued in GA
Legal business name
ERTHAL CHIROPRACTIC CENTER
Practice address
645 1St St Ste F
Macon, GA 31201-0805
Phone
(478) 742-1858
NPI assigned
Dec 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Authorized official

Name
Dr. Daniel ErthalNPI 1780729368
Title
Owner
Phone
(478) 742-1858

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 CHIR007686 GA Primary

Addresses

Primary practice location

645 1St St Ste F
Macon, GA 31201-0805

Mailing address

PO Box 34
Macon, GA 31202-0034

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100202000211 GA Part B Supplier - Clinic/Group Practice 9638212418 Receives reassigned benefits from 1 practitioner
Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Locations

144 New St
Macon, GA 31201
Phone (478) 292-2400

645 1st St
Ste F
Macon, GA 31201
Phone (478) 742-1858

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": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1649509019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312020034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 1ST ST STE F",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312010805",
            "telephone_number": "478-742-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERTHAL CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "ERTHAL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-742-1858",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.