Organization Active NPI

Coweta Chiropractic LLC

  • Chiropractor
  • Newnan, GA
National Provider Identifier
1861271280
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
COWETA CHIROPRACTIC LLC
Practice address
1201 Lower Fayetteville Rd Ste E
Newnan, GA 30265-6509
Phone
(770) 400-8707
NPI assigned
Sep 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Javier Amador Gutierrez, DC
Title
Chiropractor
Phone
(770) 400-8707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1201 Lower Fayetteville Rd Ste E
Newnan, GA 30265-6509

Mailing address

PO Box 72438
Newnan, GA 30271-2438
Phone (770) 400-8707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231106000706 GA Part B Supplier - Clinic/Group Practice 8628425139 Receives reassigned benefits from 2 practitioners
Practice locations: Newnan, GA

National Provider Directory

National Provider Directory

Locations

1201 Lower Fayetteville Rd
Ste E
Newnan, GA 30265
Phone (770) 400-8707

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1861271280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72438",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302712438",
            "telephone_number": "770-400-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 LOWER FAYETTEVILLE RD STE E",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656509",
            "telephone_number": "770-400-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COWETA CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "AMADOR GUTIERREZ",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "770-400-8707",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.