Individual provider Active NPI

Nico Anthony Staples, D.C.

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1649650615
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009463 Issued in GA
Practice address
125 Barrett Pkwy
Marietta, GA 30066-3331
Phone
(678) 324-1016
Fax
(678) 401-7647
NPI assigned
Jun 4, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009463 GA Primary

Addresses

Primary practice location

125 Barrett Pkwy
Marietta, GA 30066-3331

Mailing address

2292 Twiggs CV NW
Kennesaw, GA 30152-4208
Phone (708) 712-4973

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
100 Percent Chiropractic Atlanta Seven LLC Chiropractor CurrentSince May 21, 2016 Accepting new patients
100 Percent Chiropractic Maassen LLC Chiropractor Past Accepting new patients
100 Chiro Staples Midtown PC Chiropractor PastSince May 1, 2024 Accepting new patients
100 Chiropractic Staples Sims PLLC Chiropractor PastSince Jul 1, 2024 Accepting new patients

Locations

125 Ernest Barrett Pkwy
Marietta, GA 30066
Phone (678) 324-1016

125 Ernest Barrett Pkwy
Ste 104
Marietta, GA 30066
Phone (678) 324-1016

Organizations & group practices 4

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1649650615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2292 TWIGGS CV NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524208",
            "telephone_number": "708-712-4973",
            "fax_number": "678-401-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BARRETT PKWY",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300663331",
            "telephone_number": "678-324-1016",
            "fax_number": "678-401-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "NICO",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.