Individual provider Active NPI

Bruce R Miron, D.C.

  • Chiropractor
  • Alpharetta, GA
National Provider Identifier
1780763128
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR004763 Issued in GA
Practice address
10955 Jones Bridge Rd
Suite 111
Alpharetta, GA 30022-8109
Phone
(770) 410-1234
Fax
(770) 410-9114
NPI assigned
Nov 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR004763 GA Primary

Addresses

Primary practice location

10955 Jones Bridge Rd
Suite 111
Alpharetta, GA 30022-8109

Mailing address

10955 Jones Bridge Rd
Suite 111
Alpharetta, GA 30022-8109
Phone (770) 410-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111229000239 GA Practitioner - Chiropractic 2668648403 Practice locations: Duluth, GA; Alpharetta, GA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9590 Medlock Bridge Rd
Suite E
Duluth, GA 30097-5990
Phone (770) 410-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR004763GAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780763128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10955 JONES BRIDGE RD",
            "address_2": "SUITE 111",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300228109",
            "telephone_number": "770-410-1234",
            "fax_number": "770-410-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10955 JONES BRIDGE RD",
            "address_2": "SUITE 111",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300228109",
            "telephone_number": "770-410-1234",
            "fax_number": "770-410-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRON",
        "first_name": "BRUCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR004763",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.