Organization Active NPI

Chastain Chiropractic Office, P.C.

  • Chiropractor
  • Athens, GA
National Provider Identifier
1679612741
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
995, 8125 Issued in GA
Legal business name
CHASTAIN CHIROPRACTIC OFFICE, P.C.
Practice address
455 N Milledge Ave
Athens, GA 30601-3807
Phone
(706) 353-7778
Fax
(706) 369-8881
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jerry Dennis Chastain, D.C.
Title
President
Phone
(706) 353-7778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 995, 8125 GA Primary

Addresses

Primary practice location

455 N Milledge Ave
Athens, GA 30601-3807

Mailing address

PO Box 5552
Athens, GA 30604-5552
Phone (706) 353-7778

National Provider Directory

National Provider Directory

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679612741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5552",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306045552",
            "telephone_number": "706-353-7778",
            "fax_number": "706-369-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 N MILLEDGE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306013807",
            "telephone_number": "706-353-7778",
            "fax_number": "706-369-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHASTAIN CHIROPRACTIC OFFICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHASTAIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-353-7778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "995, 8125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • 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.