Individual provider Active NPI

David Andrew Bak, D.C.

  • Rehabilitation Chiropractor
  • Cumming, GA
National Provider Identifier
1861838690
Registry record updated May 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CHIR009147 Issued in GA
Practice address
5910 Bethelview Rd Ste C
Cumming, GA 30040-6340
Phone
(770) 573-2777
Fax
(770) 888-1176
NPI assigned
May 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CHIR009147 GA Primary

Addresses

Primary practice location

5910 Bethelview Rd Ste C
Cumming, GA 30040-6340

Mailing address

5910 Bethelview Rd Ste C
Cumming, GA 30040-6340
Phone (770) 573-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190424000194 FL Practitioner - Chiropractic 2163764119 Reassigns benefits to 1 organization
I20210104002006 GA Practitioner - Chiropractic 2163764119 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)

1400 Hembree Rd
Suite 130
Roswell, GA 30076-5711
Phone (734) 732-0928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Spine & Body Restoration Rehabilitation CurrentSince Oct 15, 2020 Accepting new patients

Locations

2500 Old Alabama Rd
Ste 20
Roswell, GA 30076
Phone (734) 732-0928

1400 Hembree Rd
Ste 130
Roswell, GA 30076
Phone (404) 671-8499

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": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1861838690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 BETHELVIEW RD STE C",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300406340",
            "telephone_number": "770-573-2777",
            "fax_number": "770-888-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 BETHELVIEW RD STE C",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300406340",
            "telephone_number": "770-573-2777",
            "fax_number": "770-888-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAK",
        "first_name": "DAVID",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR009147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; 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.