Individual provider Active NPI

Edward E. Cordovado, D.C.

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1902836026
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5041 Issued in GA
Practice address
923 Dill Ave SW
Atlanta, GA 30310-4145
Phone
(404) 753-3141
Fax
(404) 756-1070
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5041 GA Primary

Addresses

Primary practice location

923 Dill Ave SW
Atlanta, GA 30310-4145

Mailing address

923 Dill Ave SW
Atlanta, GA 30310-4145
Phone (404) 753-3141

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
5041GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Healthcare and Injury Center Chiropractor Current Accepting new patients
Sparlin Healthcare Past Accepting new patients

Locations

2896 Chamblee Tucker Rd
Ste 4
Chamblee, GA 30341
Phone (770) 457-0584

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902836026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 DILL AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303104145",
            "telephone_number": "404-753-3141",
            "fax_number": "404-756-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 DILL AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303104145",
            "telephone_number": "404-753-3141",
            "fax_number": "404-756-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVADO",
        "first_name": "EDWARD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "5041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.