Individual provider Active NPI

Jacek Czerwinski, DC

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1871238931
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010908 Issued in GA
Practice address
10917 Highway 92 Ste 160
Woodstock, GA 30188-6330
Phone
(770) 592-1915
NPI assigned
May 3, 2022
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010908 GA Primary
Sports Physician Chiropractor 111NS0005X DC-05163 OH

Addresses

Primary practice location

10917 Highway 92 Ste 160
Woodstock, GA 30188-6330

Mailing address

10917 Highway 92 Ste 160
Woodstock, GA 30188-6330
Phone (770) 592-1915

Other practice location 1

6823 Spring Valley Dr
Holland, OH 43528-9487
Phone (419) 866-6325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR010908GAMDChiropractor
DC-05163OHMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Raymond Gaskey D.C. P.C. Sports Physician CurrentSince Nov 7, 2022 Accepting new patients
Brohl Healthcare, Inc. Sports Physician CurrentSince May 1, 2022 Accepting new patients
Czerwinski Health and Wellness LLC Chiropractor CurrentSince Aug 11, 2024 Accepting new patients
Optimum Health Chiropractic, P.C. Chiropractor PastSince Aug 11, 2024 Accepting new patients

Locations

3225 Shallowford Rd
Ste 810
Marietta, GA 30062
Phone (770) 552-7979

10917 Highway 92
Ste 160
Woodstock, GA 30188
Phone (770) 592-1915

6823 Spring Valley Dr
Holland, OH 43528
Phone (419) 866-6325

Organizations & group practices 4

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": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1871238931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10917 HIGHWAY 92 STE 160",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886330",
            "telephone_number": "770-592-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10917 HIGHWAY 92 STE 160",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886330",
            "telephone_number": "770-592-1915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6823 Spring Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "OH",
            "postal_code": "435289487",
            "country_code": "US",
            "telephone_number": "419-866-6325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CZERWINSKI",
        "first_name": "JACEK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010908",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OH",
            "license": "DC-05163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.