Active NPI
Kimberly Amelia Minick, DC
- Chiropractor
- Canton, GA
National Provider Identifier
1699067728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR008433
- Practice address
- 191 E Main St
Canton, GA 30114-2708 - Phone
- (770) 757-3831
- NPI assigned
- May 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR008433 | GA | Primary |
| Nutrition Chiropractor | 111NN1001X | CHIR008433 | GA | |
| Pediatric Chiropractor | 111NP0017X | CHIR008433 | GA | |
| Rehabilitation Chiropractor | 111NR0400X | CHIR008433 | GA | |
| Sports Physician Chiropractor | 111NS0005X | CHIR008433 | GA | |
| Occupational Health Chiropractor | 111NX0100X | CHIR008433 | GA |
Addresses
Primary practice location
191 E Main St
Canton, GA 30114-2708
Mailing address
191 E Main St
Canton, GA 30114-2708
Phone (770) 757-3831
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR008433 | GA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304812800000",
"number": "1699067728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 E MAIN ST",
"city": "CANTON",
"state": "GA",
"postal_code": "301142708",
"telephone_number": "770-757-3831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 E MAIN ST",
"city": "CANTON",
"state": "GA",
"postal_code": "301142708",
"telephone_number": "770-757-3831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINICK",
"first_name": "KIMBERLY",
"middle_name": "AMELIA",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-08",
"last_updated": "2011-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR008433",
"primary": true
},
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "GA",
"license": "CHIR008433",
"primary": false
},
{
"code": "111NP0017X",
"taxonomy_group": "",
"desc": "Chiropractor, Pediatric Chiropractor",
"state": "GA",
"license": "CHIR008433",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "GA",
"license": "CHIR008433",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "GA",
"license": "CHIR008433",
"primary": false
},
{
"code": "111NX0100X",
"taxonomy_group": "",
"desc": "Chiropractor, Occupational Health",
"state": "GA",
"license": "CHIR008433",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.