Individual provider Active NPI

Deanna Dejesus Farless, D.C.

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1831521582
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009096 Issued in GA
Practice address
2323 Shallowford Rd
Ste105C
Marietta, GA 30066-2000
Phone
(770) 657-7463
NPI assigned
Aug 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009096 GA Primary
Chiropractor 111N00000X 2301010244 MI

Addresses

Primary practice location

2323 Shallowford Rd
Ste105C
Marietta, GA 30066-2000

Mailing address

2323 Shallowford Rd
Ste105C
Marietta, GA 30066-2000
Phone (770) 657-7463

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180707000138 MI Practitioner - Chiropractic 4486900388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1639 E Broomfiled St
Suite E
Mount Pleasant, MI 48858-5433
Phone (989) 954-6378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009096GAMDChiropractor
2301010244MIMDChiropractor

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": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1831521582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 SHALLOWFORD RD",
            "address_2": "STE105C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662000",
            "telephone_number": "770-657-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 SHALLOWFORD RD",
            "address_2": "STE105C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662000",
            "telephone_number": "770-657-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARLESS",
        "first_name": "DEANNA",
        "middle_name": "DEJESUS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009096",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010244",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.