Individual provider Active NPI

Marisa Ann Mikals, D.C.

  • Chiropractor
  • Acworth, GA
National Provider Identifier
1871619007
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007163 Issued in GA
Practice address
4900 Ivey Rd NW
Suite 820
Acworth, GA 30101-4001
Phone
(770) 975-9233
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007163 GA Primary

Addresses

Primary practice location

4900 Ivey Rd NW
Suite 820
Acworth, GA 30101-4001

Mailing address

2406 Owens Landing Way NW
Kennesaw, GA 30152-6551
Phone (770) 309-1816

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

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1871619007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 OWENS LANDING WAY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301526551",
            "telephone_number": "770-309-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 IVEY RD NW",
            "address_2": "SUITE 820",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014001",
            "telephone_number": "770-975-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKALS",
        "first_name": "MARISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "007163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.