NPIMap

Individual provider Active NPI

Glenn Richard Eltz, D.C.

  • Sports Physician Chiropractor
  • Woodstock, GA
National Provider Identifier
1912928185
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
2109 Issued in GA
Practice address
8720 Main St
Suite 120
Woodstock, GA 30188-4946
Phone
(770) 592-1909
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
Yes

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
Sports Physician Chiropractor 111NS0005X 2109 GA Primary

Addresses

Primary practice location

8720 Main St
Suite 120
Woodstock, GA 30188-4946

Mailing address

8720 Main St
Suite 120
Woodstock, GA 30188-4946
Phone (770) 592-1909

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

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah Hills Family Chiropractic PC Past Accepting new patients
Savannah Hills Chiropratic Past Accepting new patients

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912928185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8720 MAIN ST",
            "address_2": "SUITE 120",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884946",
            "telephone_number": "770-592-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 MAIN ST",
            "address_2": "SUITE 120",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884946",
            "telephone_number": "770-592-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTZ",
        "first_name": "GLENN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "2109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, 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.