Alpharetta Back & Neck Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

GA1707 Issued in GA

Legal business name

ALPHARETTA BACK & NECK CENTER

Practice address

3502 Old Milton Pkwy
Alpharetta, GA 30005-4458

Phone

(678) 879-4242

Fax

(678) 879-5411

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Albert J Divagno, DC

Title

DC/Owner

Phone

(678) 897-4242

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659476703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054458",
            "telephone_number": "678-879-4242",
            "fax_number": "678-879-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054458",
            "telephone_number": "678-879-4242",
            "fax_number": "678-879-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHARETTA BACK & NECK CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIVAGNO",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DC/OWNER",
        "authorized_official_telephone_number": "678-897-4242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "GA1707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.