Individual provider Active NPI

Telesa Hines Hart, DC

  • Chiropractor
  • Stone Mountain, GA
National Provider Identifier
1730889262
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010931 Issued in GA
Practice address
538 Riverbirch Trce
Stone Mountain, GA 30087-4756
Phone
(228) 760-2050
NPI assigned
Mar 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010931 GA Primary

Addresses

Primary practice location

538 Riverbirch Trce
Stone Mountain, GA 30087-4756

Mailing address

538 Riverbirch Trce
Stone Mountain, GA 30087-4756
Phone (228) 760-2050

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
CHIR010931GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hart Body and Soul Chiropractor CurrentSince Oct 13, 2024 Accepting new patients

Locations

2775 Cruse Rd
Ste 2002
Lawrenceville, GA 30044
Phone (513) 254-5562

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": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1730889262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 RIVERBIRCH TRCE",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874756",
            "telephone_number": "228-760-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 RIVERBIRCH TRCE",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874756",
            "telephone_number": "228-760-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "TELESA",
        "middle_name": "HINES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.