Chuck D Hancock, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10221 Issued in GA

Practice address

183 Keys Ferry St Ste B
McDonough, GA 30253-3232

Phone

(770) 957-7445

Fax

(770) 914-7229

NPI assigned

Mar 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972620524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 KEYS FERRY ST STE B",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533232",
            "telephone_number": "770-957-7445",
            "fax_number": "770-914-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 KEYS FERRY ST STE B",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533232",
            "telephone_number": "770-957-7445",
            "fax_number": "770-914-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "CHUCK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "10221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malik Hall
• Nina German Hall, PHD, RD, LD/N
• Tami Lillian Hall, FNP-BC
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• Shelia Hambrick, CASE MANAGER
• Jakiya Hanford, BS
• Ann Brigid Harber, FNP-C
• Harborlight Care Services LLC
• Jordan Taylor Hardin, NP
• Jena Harley, M.ED

• Dentist in McDonough, GA
• Providers in McDonough, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.