Active NPI
Gustavo Andre Perez Caballero, BS, DC, GTS
- Rehabilitation Chiropractor
- Conyers, GA
National Provider Identifier
1902572118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- CHIR010551
- Practice address
- 1379 Iris Dr SE
Conyers, GA 30013-1768 - Phone
- (404) 964-4985
- NPI assigned
- Aug 18, 2021
- Last updated
- Aug 18, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR010551 | GA | |
| Sports Physician Chiropractor | 111NS0005X | CHIR010551 | GA | |
| Orthopedic Chiropractor | 111NX0800X | CHIR010551 | GA | |
| Rehabilitation Chiropractor | 111NR0400X | CHIR010551 | GA | Primary |
Addresses
Primary practice location
1379 Iris Dr SE
Conyers, GA 30013-1768
Mailing address
3360 Steve Reynolds Blvd Apt 2411
Duluth, GA 30096-4588
Phone (470) 421-1225
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)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR010551 | GA | MD | Orthopedic Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanta Complete Care MD LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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": "1629244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1902572118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3360 STEVE REYNOLDS BLVD APT 2411",
"city": "DULUTH",
"state": "GA",
"postal_code": "300964588",
"telephone_number": "470-421-1225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1379 IRIS DR SE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300131768",
"telephone_number": "404-964-4985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ CABALLERO",
"first_name": "GUSTAVO",
"middle_name": "ANDRE",
"credential": "BS, DC, GTS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-18",
"last_updated": "2021-08-18",
"certification_date": "2021-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR010551",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "GA",
"license": "CHIR010551",
"primary": false
},
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "GA",
"license": "CHIR010551",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "GA",
"license": "CHIR010551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conyers, GA
- Avis W Peek, D.C.
- Pelagie Care Clinic
- Pelagie Foundation LTD (Pelagie Resource Center)
- Shazzanne Kahelia Pennant, MD
- Larry Pennington, RPH
- Performance Chiropractic of Georgia
- Peridot and Emerald Mobile Services, LLC
- Periodontal Center of Georgia, PC (Periodontal Center of Georgia)
- Personal Touch Healthcare LLC.
- Kimberly Anne Peters, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.