Individual provider Active NPI

Michael Weiner, DC

  • Chiropractor
  • Alpharetta, GA
National Provider Identifier
1780105965
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009872 Issued in GA
Practice address
288 S Main St
Ste 600
Alpharetta, GA 30009-1983
Phone
(845) 641-2696
NPI assigned
Jun 28, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009872 GA Primary

Addresses

Primary practice location

288 S Main St
Ste 600
Alpharetta, GA 30009-1983

Mailing address

288 S Main St
Ste 600
Alpharetta, GA 30009-1983
Phone (845) 641-2696

Other identifiers 1

IdentifierTypeStateIssuer
1780105965MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171205003464 GA Practitioner - Chiropractic 8224395926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

288 S Main St
Alpharetta, GA 30009-1983
Phone (770) 274-4840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009872GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Spine and Body LLC Chiropractor CurrentSince Jul 2, 2019 Accepting new patients

Locations

288 S Main St
Ste 600
Alpharetta, GA 30009
Phone (770) 274-4840

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": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1780105965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 S MAIN ST",
            "address_2": "STE 600",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091983",
            "telephone_number": "845-641-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 S MAIN ST",
            "address_2": "STE 600",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091983",
            "telephone_number": "845-641-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780105965",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.