Jarred Ryan Colegrove, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR007628 Issued in GA

Practice address

1335 Juanita Ave
Gainesville, GA 30501-1725

Phone

(770) 535-0550

Fax

(770) 535-1007

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• First Choice Chiropractic

  • Chiropractor
  • Gainesville, GA
  • NPI 1508242371
  Medicare reassignment NPD Authorized official
• Eddy Chiropractic Clinic Inc

  • Chiropractor
  • Williamstown, WV
  • NPI 1760413454
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1912908286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 JUANITA AVE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011725",
            "telephone_number": "770-535-0550",
            "fax_number": "770-535-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 JUANITA AVE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011725",
            "telephone_number": "770-535-0550",
            "fax_number": "770-535-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEGROVE",
        "first_name": "JARRED",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "812",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2513506",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "550785922005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7668546",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8538660",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "550785922",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLAN",
            "identifier": "WV00812",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000793",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annah Elisabeth Coker
• Zachary Colbaugh, M.D.
• James Barrett Cole, MS, CCC-SLP
• Kathryn Lyndsey Cole, DPT
• Lisa Marie Cole, MS CCC-SLP
• Elizabeth Bernice Coleman, CNM
• Holly Gilreath Coleman, M.D.
• Macayla Anne Coleman, LPC
• Olivia Jane Coley, APRN, FNP-C
• Baxter Collier, PA-C

• Chiropractor in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.