Peter James Tully, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6323 Issued in GA

Practice address

835 Jackson St
Locust Grove, GA 30248-4137

Phone

(770) 898-0028

Fax

(770) 898-7987

NPI assigned

Nov 28, 2006

Last updated

Sep 30, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1998

Medicare assignment

May accept Medicare assignment

Group practices

Locust Grove Clinic, P.C.Group PAC ID 5395733539, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Locust Grove Clinic, P.C.

  • Chiropractor
  • Locust Grove, GA
  • NPI 1699964171
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1770659161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 JACKSON ST",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302484137",
            "telephone_number": "770-898-0028",
            "fax_number": "770-898-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 JACKSON ST",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302484137",
            "telephone_number": "770-898-0028",
            "fax_number": "770-898-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "6323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Total Renal Care Inc (Locust Grove Dialysis)
• Nimisha J Trivedi, MD
• Bria Janae Truesdale, LMT, LE
• Tryst Private Homecare Inc
• Elizabeth Catherine Tully, DC
• George Turman, CRNA
• Velocity Health Partners LLC
• Villon Family Hospice
• Wal-Mart Stores East LP (Vision Center 30-5709)
• Wal-Mart Stores East LP (WalMart Pharmacy 10-5709)

• Chiropractor in Locust Grove, GA
• Providers in Locust Grove, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.