Kendra Nickerson

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR011121 Issued in GA

Practice address

40 Eastbrook BND Ste C
Peachtree City, GA 30269-1567

Phone

(770) 487-9898

NPI assigned

Feb 25, 2025

Sex

Unspecified or another gender identity

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

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fuller Life Chiropractic Center PCGroup PAC ID 7113914250, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fuller Life Chiropractic Center PC

  • Chiropractor
  • Manchester, GA
  • NPI 1417129081
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1992502397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "MANCHESTER",
            "state": "GA",
            "postal_code": "318160307",
            "telephone_number": "706-846-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EASTBROOK BND STE C",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691567",
            "telephone_number": "770-487-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "KENDRA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR011121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Rose Newton, FNP-C
• Karey Newton, RPH
• Andrea Marie Nix, MSN, RN, CPNP-PC
• Jordan M Noble, DMD
• Zola Camille Norman, PA
• Erin E Norton- Cook, CPNP-PC
• Nourishing Nutrition Consulting LLC

• Chiropractor in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.