Individual provider Active NPI

Michael Kenneth Axt, D.C.

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1912258401
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008974 Issued in GA
Practice address
1700 Northside Dr NW
Suite A3
Atlanta, GA 30318-2673
Phone
(404) 351-1800
NPI assigned
Sep 25, 2012
Last updated
May 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR008974 GA Primary

Addresses

Primary practice location

1700 Northside Dr NW
Suite A3
Atlanta, GA 30318-2673

Mailing address

5755 N Point Pkwy
Suite 72
Alpharetta, GA 30022-1142
Phone (678) 867-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251211003373 GA Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 8729572243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008974GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cory Family Chiropractic, PC Chiropractor PastSince Oct 5, 2021 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": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1912258401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 N POINT PKWY",
            "address_2": "SUITE 72",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221142",
            "telephone_number": "678-867-7200",
            "fax_number": "770-667-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NORTHSIDE DR NW",
            "address_2": "SUITE A3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182673",
            "telephone_number": "404-351-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXT",
        "first_name": "MICHAEL",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-25",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.