NPIMap

Organization Active NPI

Fairburn Road Chiropractic Clinic, Inc.

  • Chiropractor
  • Douglasville, GA
National Provider Identifier
1942577804
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR 005501 Issued in GA
Legal business name
FAIRBURN ROAD CHIROPRACTIC CLINIC, INC.
Practice address
2080 Fairburn Rd
Suite F
Douglasville, GA 30135-1064
Phone
(770) 920-1707
Fax
(770) 920-0364
NPI assigned
Nov 21, 2011
Last updated
Nov 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Authorized official

Name
Dr. Christopher J Baggett, D.C.NPI 1033273065
Title
President
Phone
(770) 920-1707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR 005501 GA Primary

Addresses

Primary practice location

2080 Fairburn Rd
Suite F
Douglasville, GA 30135-1064

Mailing address

2080 Fairburn Rd
Suite F
Douglasville, GA 30135-1064
Phone (770) 920-1707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111123000359 GA Part B Supplier - Clinic/Group Practice 5890969190 Receives reassigned benefits from 1 practitioner
Practice locations: Douglasville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1942577804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 FAIRBURN RD",
            "address_2": "SUITE F",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351064",
            "telephone_number": "770-920-1707",
            "fax_number": "770-920-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 FAIRBURN RD",
            "address_2": "SUITE F",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351064",
            "telephone_number": "770-920-1707",
            "fax_number": "770-920-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBURN ROAD CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "BAGGETT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-920-1707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR 005501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.