NPIMap

Organization Active NPI

Nguyen Chiropractic LLC

  • Chiropractor
  • Smyrna, GA
National Provider Identifier
1730425786
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008783 Issued in GA
Legal business name
NGUYEN CHIROPRACTIC LLC
Practice address
757 Concord Rd SE
Smyrna, GA 30082-2625
Phone
(770) 435-0200
Fax
(770) 435-4362
NPI assigned
Dec 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Authorized official

Name
Dr. My Nguyen, D.C.NPI 1417249673
Title
Doctor
Phone
(770) 435-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR008783 GA Primary

Addresses

Primary practice location

757 Concord Rd SE
Smyrna, GA 30082-2625

Mailing address

757 Concord Rd SE
Smyrna, GA 30082-2625
Phone (770) 435-0200

Other names 1

  • The Roeske Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130123000560 GA Part B Supplier - Clinic/Group Practice 9032362199 Receives reassigned benefits from 1 practitioner
Practice locations: Smyrna, GA

National Provider Directory

National Provider Directory

Locations

757 Concord Rd SE
Smyrna, GA 30082
Phone (770) 435-0200

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1730425786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 CONCORD RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300822625",
            "telephone_number": "770-435-0200",
            "fax_number": "770-435-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 CONCORD RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300822625",
            "telephone_number": "770-435-0200",
            "fax_number": "770-435-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGUYEN CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "770-435-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Roeske Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.