Dynamic Spine Center

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CHIR009256 Issued in GA

Legal business name

DYNAMIC SPINE CENTER

Practice address

2836 Highway 54
Suite 2836
Peachtree City, GA 30269-1026

Phone

(770) 742-9801

NPI assigned

Aug 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Dustin R Walton, D.C.NPI 1821411984

Title

Co Owner/ Clinical Director

Phone

(770) 742-9801

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dustin Walton

  • Rehabilitation Chiropractor
  • Cumming, GA
  • NPI 1821411984
  Medicare reassignment Care Compare group NPD Authorized official
• William Logan Hart, B.S., D.C.

  • Sports Physician Chiropractor
  • Peachtree City, GA
  • NPI 1891199543
  Medicare reassignment Care Compare group NPD
• Meredith Lee Jones, DC

  • Chiropractor
  • Newnan, GA
  • NPI 1104409945
  Medicare reassignment NPD
• Randall Alan Ransom Jr., DPT

  • Physical Therapist
  • Auburn, AL
  • NPI 1306124151

  GA

  Medicare reassignment
• Frank J Bostic

  • Chiropractor
  • Peachtree City, GA
  • NPI 1346966496
  NPD

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1699174896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2836 HIGHWAY 54",
            "address_2": "SUITE 2836",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691026",
            "telephone_number": "770-742-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2836 HIGHWAY 54",
            "address_2": "SUITE 2836",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691026",
            "telephone_number": "770-742-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC SPINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CO OWNER/ CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "770-742-9801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR009256",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR009256",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dunaway, PT, DPT
• Brandon Duncan
• Naomi L Duncan, LCSW
• Patricia Duncan, PA-C
• Amy Elizabeth Dunn, M.A.,CCC-SLP
• East Point Recovery Center LLC
• Vici Lynn Eckhart, MSW LCSW
• Edens Health Group Lawrenceville
• Christopher Alton Edens, MD
• Lashanda L. Edwards, LCSW

• Rehabilitation Chiropractor in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Rehabilitation Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.