Organization Active NPI

Hiram Chiropractic

  • Chiropractor
  • Hiram, GA
National Provider Identifier
1851578207
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR006046 Issued in GA
Legal business name
HIRAM CHIROPRACTIC
Practice address
4484 Jimmy Lee Smith Pkwy
Suite F 201
Hiram, GA 30141-2737
Phone
(770) 222-7555
Fax
(770) 222-1919
NPI assigned
Jan 29, 2008
Last updated
Jan 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Dr. Douglas A Laross, D.CNPI 1225127855
Title
Chiropractor
Phone
(770) 222-7555

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
Chiropractor 111N00000X CHIR006046 GA Primary

Addresses

Primary practice location

4484 Jimmy Lee Smith Pkwy
Suite F 201
Hiram, GA 30141-2737

Mailing address

4484 Jimmy Lee Smith Pkwy
Suite F 201
Hiram, GA 30141-2737
Phone (770) 222-7555

Other identifiers 1

IdentifierTypeStateIssuer
GRP4984OtherGAGROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507000296 GA Part B Supplier - Clinic/Group Practice 4486642980 Receives reassigned benefits from 1 practitioner
Practice locations: Acworth, GA

National Provider Directory

National Provider Directory

Locations

2538 Cedarcrest Rd
Ste 113
Acworth, GA 30101
Phone (770) 222-7555

4484 Jimmy Lee Smith Pkwy
Ste F201
Hiram, GA 30141
Phone (770) 222-7555

Practitioners & affiliated clinicians

Practitioners 2

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": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1851578207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4484 JIMMY LEE SMITH PKWY",
            "address_2": "SUITE F 201",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412737",
            "telephone_number": "770-222-7555",
            "fax_number": "770-222-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4484 JIMMY LEE SMITH PKWY",
            "address_2": "SUITE F 201",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412737",
            "telephone_number": "770-222-7555",
            "fax_number": "770-222-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIRAM CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "LAROSS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "770-222-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "GRP4984",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.