NPIMap

Organization Active NPI

Lighthouse Chiropractic Center

  • Chiropractor
  • Flowery Branch, GA
National Provider Identifier
1790845857
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR006987 Issued in GA
Legal business name
LIGHTHOUSE CHIROPRACTIC CENTER
Practice address
3458 Winder Hwy
Suite 120
Flowery Branch, GA 30542-3007
Phone
(770) 503-0500
Fax
(770) 503-0635
NPI assigned
Dec 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jaime Gonzalez, D.C.NPI 1669443859
Title
Owner
Phone
(770) 503-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR006987 GA Primary

Addresses

Primary practice location

3458 Winder Hwy
Suite 120
Flowery Branch, GA 30542-3007

Mailing address

3458 Winder Hwy
Suite 120
Flowery Branch, GA 30542-3007
Phone (770) 503-0500

Other identifiers 1

IdentifierTypeStateIssuer
1669443859OtherGANPI TYPE 1 NUMBER

National Provider Directory

National Provider Directory

Locations

3458 Winder Hwy
#120
Flowery Branch, GA 30542
Phone (770) 503-0500

Practitioners & affiliated clinicians

Practitioners 3

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790845857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3458 WINDER HWY",
            "address_2": "SUITE 120",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305423007",
            "telephone_number": "770-503-0500",
            "fax_number": "770-503-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3458 WINDER HWY",
            "address_2": "SUITE 120",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305423007",
            "telephone_number": "770-503-0500",
            "fax_number": "770-503-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-503-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1 NUMBER",
            "identifier": "1669443859",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowery Branch, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.