Individual provider Active NPI

Jered Michael Hull, DC, ATC, LAT

  • Chiropractor
  • Kennesaw, GA
National Provider Identifier
1841439304
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009034 Issued in GA
Practice address
3400 Blue Springs Rd NW Ste 100
Kennesaw, GA 30144-1079
Phone
(678) 574-5430
NPI assigned
Feb 6, 2009
Last updated
Feb 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT001496 GA
Chiropractor 111N00000X CHIR009034 GA Primary

Addresses

Primary practice location

3400 Blue Springs Rd NW Ste 100
Kennesaw, GA 30144-1079

Mailing address

3400 Blue Springs Rd NW Ste 100
Kennesaw, GA 30144-1079
Phone (678) 574-5430

Other identifiers 1

IdentifierTypeStateIssuer
CHIR009034OtherGASTATE LICENSING BOARD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121029000515 GA Practitioner - Chiropractic 8325298300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3400 Blue Springs NWRD
Suite 100
Kennesaw, GA 30144-1079
Phone (678) 674-5430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009034GAMDChiropractor
AT001496GAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Spine and Sports Therapy Chiropractor CurrentSince Sep 9, 2012 Accepting new patients

Locations

3400 Blue Springs Rd NW
Ste 100
Kennesaw, GA 30144
Phone (678) 574-5430

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, 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": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1841439304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 BLUE SPRINGS RD NW STE 100",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441079",
            "telephone_number": "678-574-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BLUE SPRINGS RD NW STE 100",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441079",
            "telephone_number": "678-574-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULL",
        "first_name": "JERED",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-06",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001496",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSING BOARD",
            "identifier": "CHIR009034",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; 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.