Individual provider Active NPI

Daniel Mark Gerhardt, D.C.

  • Chiropractor
  • McDonough, GA
National Provider Identifier
1801947544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4986 Issued in GA
Practice address
2101 Jonesboro Rd
McDonough, GA 30253-5915
Phone
(770) 914-0184
NPI assigned
Jan 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 4986 GA Primary

Addresses

Primary practice location

2101 Jonesboro Rd
McDonough, GA 30253-5915

Mailing address

288 Quarters Rd.
Fayetteville, GA 30215

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040713000425 GA Practitioner - Chiropractic 3678551991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2101 Jonesboro Rd
McDonough, GA 30253-5915
Phone (770) 914-0184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4986GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stockbridge Family Chiropractic, Inc. Chiropractor CurrentSince Oct 22, 1999 Accepting new patients
Eagles Landing Wellness and Chiropractic Center Inc Chiropractor Past Accepting new patients

Locations

2101 Jonesboro Rd
McDonough, GA 30253
Phone (678) 432-3303

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801947544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 QUARTERS RD.",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 JONESBORO RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302535915",
            "telephone_number": "770-914-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERHARDT",
        "first_name": "DANIEL",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "4986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, 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.