Active NPI
Adam Lee Tedder, D.C.
- Chiropractor
- Suwanee, GA
National Provider Identifier
1750687299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR008774
- Practice address
- 1500 Peachtree Industrial Blvd Ste 290
Suwanee, GA 30024-8494 - Phone
- (678) 318-2431
- Fax
- (678) 615-2368
- NPI assigned
- Feb 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR008774 | GA | Primary |
Addresses
Primary practice location
1500 Peachtree Industrial Blvd Ste 290
Suwanee, GA 30024-8494
Mailing address
1500 Peachtree Industrial Blvd Ste 290
Suwanee, GA 30024-8494
Phone (678) 318-2431
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
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR008774 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1750687299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 PEACHTREE INDUSTRIAL BLVD STE 290",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300248494",
"telephone_number": "678-318-2431",
"fax_number": "678-615-2368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 PEACHTREE INDUSTRIAL BLVD STE 290",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300248494",
"telephone_number": "678-318-2431",
"fax_number": "678-615-2368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDDER",
"first_name": "ADAM",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-01",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR008774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.