Individual provider Active NPI

Curtis Edward Harraway Jr., D.C.

  • Chiropractor
  • Greensboro, GA
National Provider Identifier
1710928064
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005689 Issued in GA
Practice address
1031 Parkside CMNS
Ste 103
Greensboro, GA 30642-4520
Phone
(706) 453-7411
Fax
(706) 453-7138
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 005689 GA Primary

Addresses

Primary practice location

1031 Parkside CMNS
Ste 103
Greensboro, GA 30642-4520

Mailing address

1031 Parkside CMNS Ste 103
Greensboro, GA 30642-4520
Phone (706) 453-7411

Other identifiers 1

IdentifierTypeStateIssuer
35ZCJPPOtherMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051020000527 GA Practitioner - Chiropractic 1254357098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1031 Parkside CMNS
Suite 103
Greensboro, GA 30642-4520
Phone (706) 453-7411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005689GAMDChiropractor

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1710928064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 PARKSIDE CMNS STE 103",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306424520",
            "telephone_number": "706-453-7411",
            "fax_number": "706-453-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 PARKSIDE CMNS",
            "address_2": "STE 103",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306424520",
            "telephone_number": "706-453-7411",
            "fax_number": "706-453-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRAWAY",
        "first_name": "CURTIS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "005689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "35ZCJPP",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.