Broad Axe Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC003375L Issued in PA

Legal business name

BROAD AXE CHIROPRACTIC CENTER

Practice address

914 Skippack Pike
Blue Bell, PA 19422-1535

Phone

(215) 540-0776

Fax

(215) 570-9022

NPI assigned

Sep 24, 2007

Last updated

May 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marie Winans

Title

Office MGR

Phone

(215) 540-0776

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

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.

• Patricia A Bona-Kustra, D.C.

  • Orthopedic Chiropractor
  • Blue Bell, PA
  • NPI 1851346290
  Medicare reassignment Care Compare group NPD
• Robert J Kustra, DC

  • Orthopedic Chiropractor
  • Blue Bell, PA
  • NPI 1518906668
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1013103993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 SKIPPACK PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221535",
            "telephone_number": "215-540-0776",
            "fax_number": "215-570-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 SKIPPACK PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221535",
            "telephone_number": "215-540-0776",
            "fax_number": "215-570-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD AXE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "WINANS",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "215-540-0776"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC003375L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin E Brady
• Sharon Lynn Brauer, CRNP
• Danielle Brazinski, ATR-BC, LPC
• Kelly Brennan
• Kristen Brent, CCC-SLP
• Broad Axe Family Dentistry
• Rebecca Brossman
• Bayleigh Brown
• Cleveland D Brown, D.C.
• Emily Brown

• Chiropractor in Blue Bell, PA
• Providers in Blue Bell, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.