Nicole Marie Benge, D.C.
Individual provider Active NPI Chiropractor · Dallas, GA
NPI 1912945486 · NPPES record last updated Jun 28, 2012
Key facts
- NPI
- 1912945486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 007600 (GA)
- Practice address
- 115 Sugar Berry PL
Suite 119
Dallas, GA 30157-7189 - Phone
- (678) 778-6955
- NPI assigned
- Jun 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthsprout LLC | Chiropractor | Past | Accepting new patients |
| Pham Chiropractic Services, PC | Chiropractor | Past | Accepting new patients |
| Team Chiropractic P.C. | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 007600 | GA | Yes |
Addresses
Primary practice location
115 Sugar Berry PL
Suite 119
Dallas, GA 30157-7189
Mailing address
115 Sugar Berry PL
Suite 119
Dallas, GA 30157-7189
Phone (678) 778-6955
Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.