NPIMap

Organization Active NPI

S. Eagle Rd Chiropractic Inc

  • Chiropractor
  • Havertown, PA
National Provider Identifier
1003889536
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-004701-L Issued in PA
Legal business name
S. EAGLE RD CHIROPRACTIC INC
Practice address
31 S. Eagle Rd Suite 101
Havertown, PA 19083
Phone
(610) 789-7669
Fax
(610) 789-7672
NPI assigned
Feb 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Authorized official

Name
Dr. Laura Bailey, DC
Title
Owner Doctor
Phone
(610) 789-7669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC-004701-L PA Primary

Addresses

Primary practice location

31 S. Eagle Rd Suite 101
Havertown, PA 19083

Mailing address

31 S. Eagle Rd Suite 101
Havertown, PA 19083
Phone (610) 789-7669

Other identifiers 1

IdentifierTypeStateIssuer
02592247MedicaidPA

National Provider Directory

National Provider Directory

Locations

31 S Eagle Rd
Ste 101
Havertown, PA 19083
Phone (610) 789-7669

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1003889536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 S. EAGLE RD SUITE 101",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "19083",
            "telephone_number": "610-789-7669",
            "fax_number": "610-789-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S. EAGLE RD SUITE 101",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "19083",
            "telephone_number": "610-789-7669",
            "fax_number": "610-789-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. EAGLE RD CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "610-789-7669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-004701-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02592247",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; 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.