Individual provider Active NPI

Catherine Harris Mayberry, D.C.

  • Chiropractor
  • Calhoun, GA
National Provider Identifier
1851652432
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR00897 Issued in GA
Practice address
200 Professional CT SE Ste 1
Calhoun, GA 30701-7020
Phone
(706) 602-9696
NPI assigned
May 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR00897 GA Primary

Addresses

Primary practice location

200 Professional CT SE Ste 1
Calhoun, GA 30701-7020

Mailing address

200 Professional CT SE Ste 1
Calhoun, GA 30701-7020
Phone (706) 602-9696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120813000578 GA Practitioner - Chiropractic 1951557669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

105 JW Plaza Dr
Suite 5
Calhoun, GA 30701-1503

105 JW Plaza Dr SE
Suite 5
Calhoun, GA 30701-1503
Phone (762) 204-2138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR00897GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Chiropractic Chiropractor CurrentSince Nov 28, 2022 Accepting new patients
Ledford Chiropractic, P.C. Chiropractor Past Accepting new patients

Locations

105 Jw Plaza Dr SE
Ste 5
Calhoun, GA 30701
Phone (706) 466-7076

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1851652432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PROFESSIONAL CT SE STE 1",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307017020",
            "telephone_number": "706-602-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROFESSIONAL CT SE STE 1",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307017020",
            "telephone_number": "706-602-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "CATHERINE",
        "middle_name": "HARRIS",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR00897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.