Individual provider Active NPI

Robert Michael Dahl, D.C.

  • Chiropractor
  • Flagstaff, AZ
National Provider Identifier
1013082668
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5436 Issued in AZ
Practice address
2622 N Steves Blvd
Flagstaff, AZ 86004-3938
Phone
(928) 226-7191
Fax
(928) 526-5767
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5436 AZ Primary

Addresses

Primary practice location

2622 N Steves Blvd
Flagstaff, AZ 86004-3938

Mailing address

2622 N Steves Blvd
Flagstaff, AZ 86004-3938
Phone (928) 226-7191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101000671 AZ Practitioner - Chiropractic 5294797387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2717 N 4TH St
Flagstaff, AZ 86004-1813
Phone (928) 226-7191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5436AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
R.M. Dahl Chiropractic & Functional Medicine, Inc. Chiropractor CurrentSince Jan 27, 2000 Accepting new patients
Az North Pain & Rehab Past Accepting new patients

Locations

2717 N 4th St
Ste 120
Flagstaff, AZ 86004
Phone (520) 226-7191

2622 N Steves Blvd
Flagstaff, AZ 86004
Phone (520) 226-7191

Organizations & group practices 2

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013082668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 N STEVES BLVD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043938",
            "telephone_number": "928-226-7191",
            "fax_number": "928-526-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 N STEVES BLVD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043938",
            "telephone_number": "928-226-7191",
            "fax_number": "928-526-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • 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.