Organization Active NPI

Stacey a Duckett Chiropractic Corporation

  • Chiropractor
  • Antioch, CA
National Provider Identifier
1013155423
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
STACEY A DUCKETT CHIROPRACTIC CORPORATION
Practice address
1407 A St
D
Antioch, CA 94509-2357
Phone
(925) 777-3334
NPI assigned
Jan 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Authorized official

Name
Dr. Stacey Duckett, D.C.NPI 1093994048
Title
President
Phone
(925) 777-3334

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CA Primary

Addresses

Primary practice location

1407 A St
D
Antioch, CA 94509-2357

Mailing address

1407 A St
D
Antioch, CA 94509-2357
Phone (925) 777-3334

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090316000602 CA Part B Supplier - Clinic/Group Practice 6103877311 Receives reassigned benefits from 1 practitioner
Practice locations: Antioch, CA

National Provider Directory

National Provider Directory

Locations

4099 Lone Tree Way
Antioch, CA 94531
Phone (925) 513-6168

3432 Hillcrest Ave
Ste 200
Antioch, CA 94531
Phone (925) 757-3309

1407 A St
Ste D
Antioch, CA 94509
Phone (925) 759-1011

160 Guthrie Ln
Ste 5
Brentwood, CA 94513
Phone (925) 513-6168

703 Market St
Ste 1308
San Francisco, CA 94103
Phone (415) 512-2700

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1013155423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 A ST",
            "address_2": "D",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945092357",
            "telephone_number": "925-777-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 A ST",
            "address_2": "D",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945092357",
            "telephone_number": "925-777-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY A DUCKETT CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-23",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-777-3334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; 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.