Organization Active NPI

Advanced Chiropractic & Rehab, PC

  • Chiropractor
  • Lancaster, PA
National Provider Identifier
1003861907
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC008781 Issued in PA
Legal business name
ADVANCED CHIROPRACTIC & REHAB, PC
Practice address
900B Centerville Rd
Lancaster, PA 17601-1416
Phone
(717) 898-8900
Fax
(717) 898-6009
NPI assigned
May 23, 2006
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Dr. Rustin W Glass, DCNPI 1346219391
Title
Owner
Phone
(717) 898-8900

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
Chiropractor 111N00000X DC008781 PA Primary

Addresses

Primary practice location

900B Centerville Rd
Lancaster, PA 17601-1416

Mailing address

900B Centerville Rd
Lancaster, PA 17601-1416
Phone (717) 898-8900

Other identifiers 4

IdentifierTypeStateIssuer
P00231877OtherPARAILROAD MEDICARE
1190412OtherPAAETNA
AD1775455OtherPAHIGHMARK BLUE SHIELD
50003718OtherPACAPITAL BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060112000537 PA Part B Supplier - Clinic/Group Practice 5294758553 Receives reassigned benefits from 1 practitioner
Practice locations: Lancaster, PA

National Provider Directory

National Provider Directory

Locations

900 Centerville Rd
Ste B
Lancaster, PA 17601
Phone (717) 898-7489

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1003861907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900B CENTERVILLE RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176011416",
            "telephone_number": "717-898-8900",
            "fax_number": "717-898-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900B CENTERVILLE RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176011416",
            "telephone_number": "717-898-8900",
            "fax_number": "717-898-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHIROPRACTIC & REHAB, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "GLASS",
        "authorized_official_first_name": "RUSTIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-898-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00231877",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1190412",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "AD1775455",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50003718",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.