NPIMap

Organization Active NPI

Back to Basic Health Chiropractic

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1770796203
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4718 Issued in GA
Legal business name
BACK TO BASIC HEALTH CHIROPRACTIC
Practice address
5101 Old Hwy 5
Suite 1
Woodstock, GA 30188
Phone
(678) 494-6735
Fax
(678) 494-6737
NPI assigned
May 8, 2007
Last updated
Oct 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Authorized official

Name
Ms. Kimberly Anne Vaccaro, DCNPI 1427261957
Title
Owner
Phone
(678) 494-6735

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4718 GA Primary

Addresses

Primary practice location

5101 Old Hwy 5
Suite 1
Woodstock, GA 30188

Mailing address

PO Box 2031
Acworth, GA 30102
Phone (678) 494-6735

Other identifiers 2

IdentifierTypeStateIssuer
00804207AMedicaidGA
4718OtherCHIROPRACTIC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1770796203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2031",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "30102",
            "telephone_number": "678-494-6735",
            "fax_number": "678-494-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 OLD HWY 5",
            "address_2": "SUITE 1",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30188",
            "telephone_number": "678-494-6735",
            "fax_number": "678-494-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO BASIC HEALTH CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "VACCARO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-494-6735",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "4718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00804207A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC",
            "identifier": "4718",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.