Individual provider Active NPI

Aimee Jacob Trust, DC

  • Chiropractor
  • Newnan, GA
National Provider Identifier
1932697471
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010019 Issued in GA
Practice address
931 Lower Fayetteville Rd
Newnan, GA 30263-5790
Phone
(770) 683-6884
NPI assigned
Apr 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010019 GA Primary

Addresses

Primary practice location

931 Lower Fayetteville Rd
Newnan, GA 30263-5790

Mailing address

931 Lower Fayetteville Rd
Ste H
Newnan, GA 30263-5790
Phone (801) 391-5799

Other names 1

  • Aimee Jacob Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180615001298 GA Practitioner - Chiropractic 7517212541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Family WellnessGroup PAC ID 5395917736, 2 clinicians

Practice addresses (Care Compare)

931 Lower Fayetteville Rd
Suite H
Newnan, GA 30263-5790
Phone (770) 683-6884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Family Wellness Chiropractor CurrentSince May 3, 2018 Accepting new patients

Locations

931 Lower Fayetteville Rd
Ste H
Newnan, GA 30263
Phone (706) 683-6884

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1932697471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 LOWER FAYETTEVILLE RD",
            "address_2": "STE H",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302635790",
            "telephone_number": "801-391-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 LOWER FAYETTEVILLE RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302635790",
            "telephone_number": "770-683-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUST",
        "first_name": "AIMEE",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIMEE",
            "last_name": "JACOB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.