Colleen Candace Cork, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 25114 Issued in CA

Practice address

1227 Buena Vista St
Suite D
Duarte, CA 91010-2486

Phone

(626) 303-4988

Fax

(626) 303-7059

NPI assigned

Oct 16, 2006

Sex

Female

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 CA

Enrollment records 1

Specialty

Chiropractic

Education

Los Angeles College of Chiropractic, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25636/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003996810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 BUENA VISTA ST",
            "address_2": "SUITE D",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102486",
            "telephone_number": "626-303-4988",
            "fax_number": "626-303-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 BUENA VISTA ST",
            "address_2": "SUITE D",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102486",
            "telephone_number": "626-303-4988",
            "fax_number": "626-303-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORK",
        "first_name": "COLLEEN",
        "middle_name": "CANDACE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 25114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Duarte, CA
• Providers in Duarte, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.