Individual provider Active NPI

Jessica Lofgren, DC

  • Neurology Chiropractor
  • Marietta, GA
National Provider Identifier
1740794866
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
CHIR009968 Issued in GA
Practice address
1130 Northchase Pkwy SE Ste 125
Marietta, GA 30067
Phone
(770) 664-4288
NPI assigned
Nov 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X CHIR009968 GA Primary

Addresses

Primary practice location

1130 Northchase Pkwy SE Ste 125
Marietta, GA 30067

Mailing address

180 Jackson St NE Apt 3507
Atlanta, GA 30312-7923
Phone (540) 604-3434

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
CHIR009968GAMDNeurology Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1740794866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 JACKSON ST NE APT 3507",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303127923",
            "telephone_number": "540-604-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NORTHCHASE PKWY SE STE 125",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30067",
            "telephone_number": "770-664-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFGREN",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "GA",
            "license": "CHIR009968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.