Individual provider Active NPI

Jessica Villa Tew, DOCTOR OF CHIROPRACT

  • Chiropractor
  • Alpharetta, GA
National Provider Identifier
1942719927
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2056 Issued in CT
Practice address
480 N Main St Ste 201
Alpharetta, GA 30009-8386
Phone
(770) 864-1195
Fax
(770) 864-1169
NPI assigned
Sep 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2056 CT Primary

Addresses

Primary practice location

480 N Main St Ste 201
Alpharetta, GA 30009-8386

Mailing address

480 N Main St Ste 201
Alpharetta, GA 30009-8386
Phone (770) 864-1195

Other practice location 1

2480 Sandy Plains Rd
Marietta, GA 30066-5776
Phone (770) 485-0322

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211013002721 GA Practitioner - Chiropractic 3375941834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2633 Freedom Pkwy
Cumming, GA 30041-9176
Phone (470) 789-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2056CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Chiropractic of Ga, PC Chiropractor CurrentSince Jul 8, 2021 Accepting new patients
NC Chiro Ventures Inc Chiropractor CurrentSince Jul 1, 2022 Accepting new patients
Friends & Family Chiropractic Chiropractor Past Accepting new patients

Locations

480 N Main St
Ste 201
Alpharetta, GA 30009
Phone (770) 864-1195

2633 Freedom Pkwy
Cumming, GA 30041
Phone (470) 789-5700

Organizations & group practices 3

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": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1942719927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 N MAIN ST STE 201",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300098386",
            "telephone_number": "770-864-1195",
            "fax_number": "770-864-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 N MAIN ST STE 201",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300098386",
            "telephone_number": "770-864-1195",
            "fax_number": "770-864-1169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2480 Sandy Plains Rd",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300665776",
            "country_code": "US",
            "telephone_number": "770-485-0322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEW",
        "first_name": "JESSICA",
        "middle_name": "VILLA",
        "credential": "DOCTOR OF CHIROPRACT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2021-08-23",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "2056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.