Full Body Rejuvenetion Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR007963 Issued in GA

Legal business name

FULL BODY REJUVENETION CENTER, LLC

Practice address

3636 Panola Rd
Suite B
Lithonia, GA 30038-2733

Phone

(678) 609-1586

NPI assigned

Jun 16, 2008

Organization subpart

No

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

Authorized official

Name

Nailah Smith, D.C.NPI 1144377813

Title

Chiropractor/Owner

Phone

(678) 613-4650

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nailah Asha Smith, D. C.

  • Chiropractor
  • Lithonia, GA
  • NPI 1144377813
  Medicare reassignment NPD Authorized official
• Courtney Acree, D.C.

  • Chiropractor
  • Stonecrest, GA
  • NPI 1922307073
  NPD

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1790945475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 PANOLA RD",
            "address_2": "SUITE B",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382733",
            "telephone_number": "678-609-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 PANOLA RD",
            "address_2": "SUITE B",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382733",
            "telephone_number": "678-609-1586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL BODY REJUVENETION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NAILAH",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "678-613-4650",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.