Brenna Renee Roden, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR010359 Issued in GA

Practice address

1685 Mars Hill Rd NW Ste 103
Acworth, GA 30101-7180

Phone

(770) 218-0400

Fax

(770) 218-1160

NPI assigned

Apr 27, 2020

Last updated

Apr 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lost Mountain Chiropractic Family and Pediatrics LLC

  • Chiropractor
  • Acworth, GA
  • NPI 1841802014
  Medicare reassignment NPD Authorized official
• Dr. Delaram Shekarriz Inc.

  dba Lost mountain chiropractic

  • Chiropractor
  • Acworth, GA
  • NPI 1538677943
  NPD

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1689295081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 MARS HILL RD NW STE 103",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017180",
            "telephone_number": "770-218-0400",
            "fax_number": "770-218-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 MARS HILL RD NW STE 103",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017180",
            "telephone_number": "770-218-0400",
            "fax_number": "770-218-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEN",
        "first_name": "BRENNA",
        "middle_name": "RENEE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Nelson Rivera, M.S., L.P.C.
• Bryan Rivera, ATC, LAT
• Gordon Todd Robbins, M.D.
• Amanda Kristine Roberts, ATC
• May Amanukpo Robinson, MD
• Candice Rolle
• Raven Paulette Rose, PA
• Richard Martin Rosenberger, M.D.
• Emily E Ross, PA-C
• Kylie Victoria Ross

• Chiropractor in Acworth, GA
• Providers in Acworth, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.