Organization Active NPI

Valdosta Chiropractic & Rehab, LLC

  • Chiropractor
  • Valdosta, GA
National Provider Identifier
1972822377
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008575 Issued in GA
Legal business name
VALDOSTA CHIROPRACTIC & REHAB, LLC
Practice address
701 Baytree Rd
Suite D
Valdosta, GA 31602-2880
Phone
(229) 247-2828
NPI assigned
May 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2010

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

Authorized official

Name
Dr. Jana Lacie Guy, D.C.NPI 1730401902
Title
Owner
Phone
(229) 247-2828

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 CHIR008575 GA Primary

Addresses

Primary practice location

701 Baytree Rd
Suite D
Valdosta, GA 31602-2880

Mailing address

PO Box 5192
Valdosta, GA 31603-5192
Phone (229) 247-2828

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100601000475 GA Part B Supplier - Clinic/Group Practice 3274662259 Receives reassigned benefits from 2 practitioners
Practice locations: Valdosta, GA

National Provider Directory

National Provider Directory

Locations

220 Gornto Rd
Valdosta, GA 31602
Phone (229) 247-2828

Practitioners & affiliated clinicians

Practitioners 2

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": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1972822377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5192",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316035192",
            "telephone_number": "229-247-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BAYTREE RD",
            "address_2": "SUITE D",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022880",
            "telephone_number": "229-247-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALDOSTA CHIROPRACTIC & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "GUY",
        "authorized_official_first_name": "JANA",
        "authorized_official_middle_name": "LACIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-247-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.