Individual provider Active NPI

Lisa N Mielcarski, D.C

  • Chiropractor
  • Carrollton, GA
National Provider Identifier
1992889497
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO007252 Issued in GA
Practice address
624 Newnan St
Carrollton, GA 30117-3429
Phone
(770) 834-6669
Fax
(770) 834-4814
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO007252 GA Primary

Addresses

Primary practice location

624 Newnan St
Carrollton, GA 30117-3429

Mailing address

8 Mountain Brooke Dr
Carrollton, GA 30116-6490
Phone (678) 462-4402

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090225000217 GA Practitioner - Chiropractic 2062572431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danber IncGroup PAC ID 1254491624, 2 clinicians

Practice addresses (Care Compare)

210 S St
Carrollton, GA 30117-3738
Phone (770) 834-6669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO007252GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
HTB Consulting Chiropractor Current Accepting new patients
Danber Inc Chiropractor CurrentSince Jan 1, 2003 Accepting new patients
West Georgia Healthcare Current Accepting new patients

Locations

624 Newnan St
Carrollton, GA 30117
Phone (770) 834-6669

210 South St
Carrollton, GA 30117
Phone (770) 834-1898

Organizations & group practices 3

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1992889497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MOUNTAIN BROOKE DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301166490",
            "telephone_number": "678-462-4402",
            "fax_number": "770-834-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 NEWNAN ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173429",
            "telephone_number": "770-834-6669",
            "fax_number": "770-834-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIELCARSKI",
        "first_name": "LISA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO007252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.