Individual provider Active NPI

Daniel James Mielcarski, DC

  • Chiropractor
  • Carrollton, GA
National Provider Identifier
1689715690
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
07218 Issued in GA
Practice address
624 Newnan St
Carrollton, GA 30117-3429
Phone
(770) 834-6669
Fax
(770) 834-4814
NPI assigned
Feb 11, 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 07218 GA Primary

Addresses

Primary practice location

624 Newnan St
Carrollton, GA 30117-3429

Mailing address

8 Mountain Brooke Dr
Carrollton, GA 30116-6490
Phone (678) 852-4070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
07218GAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689715690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MOUNTAIN BROOKE DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301166490",
            "telephone_number": "678-852-4070",
            "fax_number": "770-834-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 NEWNAN ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173429",
            "telephone_number": "770-834-6669",
            "fax_number": "770-834-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIELCARSKI",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "07218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.