Organization Active NPI

Body in Balance Chiropractic & Wellness Center, LLC

  • Chiropractor
  • Fayetteville, GA
National Provider Identifier
1962705970
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008592 Issued in GA
Legal business name
BODY IN BALANCE CHIROPRACTIC & WELLNESS CENTER, LLC
Practice address
185 Georgia Ave E
Fayetteville, GA 30214-1615
Phone
(770) 461-0055
NPI assigned
Dec 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Authorized official

Name
Dr. Alisha M Mayheu, D.C.NPI 1821329293
Title
Organizer
Phone
(404) 353-6030

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR008592 GA Primary

Addresses

Primary practice location

185 Georgia Ave E
Fayetteville, GA 30214-1615

Mailing address

185 Georgia Ave E
Fayetteville, GA 30214-1615
Phone (770) 461-0055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140912001741 GA Part B Supplier - Clinic/Group Practice 1254516594 Receives reassigned benefits from 1 practitioner
Practice locations: Fayetteville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1962705970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 GEORGIA AVE E",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141615",
            "telephone_number": "770-461-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 GEORGIA AVE E",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141615",
            "telephone_number": "770-461-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY IN BALANCE CHIROPRACTIC & WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "MAYHEU",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "404-353-6030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.