Individual provider Active NPI

David Adam Shapiro, DC

  • Chiropractor
  • Tucker, GA
National Provider Identifier
1669510178
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005099 Issued in GA
Practice address
2347 Brockett Road
Tucker, GA 30084
Phone
(770) 938-4606
Fax
(404) 231-9953
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR005099 GA Primary

Addresses

Primary practice location

2347 Brockett Road
Tucker, GA 30084

Mailing address

2347 Brockett Road
Tucker, GA 30084-4474
Phone (770) 938-4606

Other identifiers 3

IdentifierTypeStateIssuer
350055211OtherGARAILROAD MEDICARE
393551OtherGABCBS
911976648OtherGATAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111130000865 GA Practitioner - Chiropractic 3971680679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2347 Brockett Rd
Tucker, GA 30084-4474
Phone (770) 938-4606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR005099GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Spine Solutions, PC Chiropractor CurrentSince Aug 2, 2002 Accepting new patients

Locations

2347 Brockett Rd
Tucker, GA 30084
Phone (770) 938-4606

Organizations & group practices 1

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669510178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 BROCKETT ROAD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844474",
            "telephone_number": "770-938-4606",
            "fax_number": "404-231-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 BROCKETT ROAD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "770-938-4606",
            "fax_number": "404-231-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "DAVID",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350055211",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "393551",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "911976648",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.