Active NPI
Amanda Ruth Davis, DC,
- Chiropractor
- Stockbridge, GA
National Provider Identifier
1649901513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR010782
- Practice address
- 5124 N Henry Blvd
Stockbridge, GA 30281-3232 - Phone
- (770) 474-6680
- NPI assigned
- Jun 22, 2022
- 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 | CHIR010782 | GA | Primary |
Addresses
Primary practice location
5124 N Henry Blvd
Stockbridge, GA 30281-3232
Mailing address
5124 N Henry Blvd
Stockbridge, GA 30281-3232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220803001395 | GA | Practitioner - Chiropractic | 6800278193 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1649901513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5124 N HENRY BLVD",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302813232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5124 N HENRY BLVD",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302813232",
"telephone_number": "770-474-6680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "AMANDA",
"middle_name": "RUTH",
"name_prefix": "Dr.",
"credential": "DC,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-22",
"last_updated": "2022-06-22",
"certification_date": "2022-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR010782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.