Organization Active NPI

Daugherty Chiropractic & Family Wellness PC

  • Chiropractor
  • Las Cruces, NM
National Provider Identifier
1013948512
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1654 Issued in NM
Legal business name
DAUGHERTY CHIROPRACTIC & FAMILY WELLNESS PC
Practice address
648 N Alameda Blvd
Las Cruces, NM 88005-2131
Phone
(575) 521-0022
Fax
(575) 521-0033
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Authorized official

Name
Dr. Chris W Daugherty, D.C.NPI 1558328088
Title
Owner
Phone
(575) 521-0022

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 1654 NM Primary

Addresses

Primary practice location

648 N Alameda Blvd
Las Cruces, NM 88005-2131

Mailing address

648 N Alameda Blvd
Las Cruces, NM 88005-2131
Phone (575) 521-0022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060911000665 NM Part B Supplier - Clinic/Group Practice 8729082474 Receives reassigned benefits from 1 practitioner
Practice locations: Las Cruces, NM

National Provider Directory

National Provider Directory

Locations

648 N Alameda Blvd
Las Cruces, NM 88005
Phone (575) 521-0022

Practitioners & affiliated clinicians

Practitioners 2

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": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1013948512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 N ALAMEDA BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052131",
            "telephone_number": "575-521-0022",
            "fax_number": "575-521-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 N ALAMEDA BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052131",
            "telephone_number": "575-521-0022",
            "fax_number": "575-521-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAUGHERTY CHIROPRACTIC & FAMILY WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-521-0022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.