Individual provider Active NPI

Richard D Buchanan, DC

  • Chiropractor
  • Stockbridge, GA
National Provider Identifier
1790788131
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR002282 Issued in GA
Practice address
5124 N Henry Blvd
Stockbridge, GA 30281-3232
Phone
(770) 474-6680
Fax
(770) 474-3633
NPI assigned
May 31, 2005
Reactivated
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR002282 GA Primary

Addresses

Primary practice location

5124 N Henry Blvd
Stockbridge, GA 30281-3232

Mailing address

PO Box 2160
Stockbridge, GA 30281-8909
Phone (770) 474-6680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050308000011 GA Practitioner - Chiropractic 8820989494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5124 N Henry Blvd
Stockbridge, GA 30281-3232
Phone (770) 474-6680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2282GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Buchanan Chiropractic Clinic PC Chiropractor CurrentSince Jul 1, 1966 Accepting new patients

Locations

5124 N Henry Blvd
Stockbridge, GA 30281
Phone (770) 474-6680

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1790788131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2160",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302818909",
            "telephone_number": "770-474-6680",
            "fax_number": "770-474-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5124 N HENRY BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813232",
            "telephone_number": "770-474-6680",
            "fax_number": "770-474-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "RICHARD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2012-09-14",
        "deactivation_date": "2006-04-04",
        "reactivation_date": "2006-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR002282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.