Individual provider Active NPI

Katherine Alexia Wilson, DC

  • Chiropractor
  • Dunwoody, GA
National Provider Identifier
1972225001
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009416 Issued in GA
Practice address
2494 Jett Ferry Rd
Dunwoody, GA 30338-3090
Phone
(678) 205-1573
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009416 GA Primary

Addresses

Primary practice location

2494 Jett Ferry Rd
Dunwoody, GA 30338-3090

Mailing address

2494 Jett Ferry Rd
Dunwoody, GA 30338-3090
Phone (678) 205-1573

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230208001174 GA Practitioner - Chiropractic 1456723063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilson Family ChiropracticGroup PAC ID 5890820567, 3 clinicians

Practice addresses (Care Compare)

2498 Jett Ferry Rd
Suite 100
Dunwoody, GA 30338-3062
Phone (404) 805-5961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Family Chiropractic Chiropractor CurrentSince Nov 1, 2022 Accepting new patients

Locations

2498 Jett Ferry Rd
Ste 100
Dunwoody, GA 30338
Phone (404) 805-5961

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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1972225001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2494 JETT FERRY RD",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303383090",
            "telephone_number": "678-205-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2494 JETT FERRY RD",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303383090",
            "telephone_number": "678-205-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHERINE",
        "middle_name": "ALEXIA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.