NPIMap

Organization Active NPI

Optimum Performance Chiropractic & Wellness LLC.

Doing business as Living Proof Chiropractic

  • Chiropractor
  • Johns Creek, GA
National Provider Identifier
1801570742
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
OPTIMUM PERFORMANCE CHIROPRACTIC & WELLNESS LLC.
Doing business as
Living Proof Chiropractic
Practice address
11130 State Bridge Rd Ste C102
Johns Creek, GA 30022-2640
Phone
(770) 521-9008
NPI assigned
Jun 12, 2023
Last updated
Jun 12, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
OPTIMUM PERFORMANCE CHIROPRACTIC & WELLNESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Authorized official

Name
James Paul FerranteNPI 1841838356
Title
Clinic Director/ Ceo
Phone
(631) 786-6139

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
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

11130 State Bridge Rd Ste C102
Johns Creek, GA 30022-2640

Mailing address

1301 Shiloh Rd NW Ste 420
Kennesaw, GA 30144-7152
Phone (470) 308-4108

Other names 1

  • Living Proof Chiropractic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Optimum Performance Chiropractic Wellness LLC2 organizations share this tax ID, including this one
Part of
Optimum Performance Chiropractic Wellness LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11130 State Bridge Rd
Ste C102
Johns Creek, GA 30022
Phone (678) 403-2121

1301 Shiloh Rd NW
Ste 420
Kennesaw, GA 30144
Phone (470) 308-4108

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1801570742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SHILOH RD NW STE 420",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447152",
            "telephone_number": "470-308-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 STATE BRIDGE RD STE C102",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300222640",
            "telephone_number": "770-521-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PERFORMANCE CHIROPRACTIC & WELLNESS LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTIMUM PERFORMANCE CHIROPRACTIC & WELLNESS LLC",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "FERRANTE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CLINIC DIRECTOR/ CEO",
        "authorized_official_telephone_number": "631-786-6139"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Proof Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.