South Atlanta Spine and Wellness Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR006553 Issued in GA

Legal business name

SOUTH ATLANTA SPINE AND WELLNESS CENTER

Practice address

288 Highway 314
Suite C
Fayetteville, GA 30214-7830

Phone

(678) 817-4053

Fax

(675) 817-4058

NPI assigned

Nov 16, 2006

Last updated

Oct 28, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ian Bradley Brunet, D.C., BCAONPI 1427120013

Title

Owner

Phone

(678) 817-4053

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ian Bradley Brunet, D.C., BCAO

  • Chiropractor
  • Fayetteville, GA
  • NPI 1427120013
  Authorized official Same address or phone

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1992878391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 HWY 314",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141385",
            "telephone_number": "678-817-4053",
            "fax_number": "675-817-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 HIGHWAY 314",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147830",
            "telephone_number": "678-817-4053",
            "fax_number": "675-817-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATLANTA SPINE AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "BRUNET",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-817-4053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., BCAO"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.