Individual provider Active NPI

Derek Patrick Price, D.C.

  • Chiropractor
  • Bullhead City, AZ
National Provider Identifier
1023177672
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5736 Issued in AZ
Practice address
1868 Highway 95
Bullhead City, AZ 86442-6804
Phone
(928) 763-8313
Fax
(928) 763-7995
NPI assigned
Dec 8, 2006
Last updated
Nov 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5736 AZ Primary

Addresses

Primary practice location

1868 Highway 95
Bullhead City, AZ 86442-6804

Mailing address

2996 Desierto Verde
Bullhead City, AZ 86429-5842
Phone (928) 754-3884

Other identifiers 1

IdentifierTypeStateIssuer
5736OtherAZSTATE LICENCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901001259 AZ Practitioner - Chiropractic 5395637888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derek Price Chiropractic PLLCGroup PAC ID 4082655360, 2 clinicians

Practice addresses (Care Compare)

1868 Hway
Suite 95
Bullhead City, AZ 86442-6800
Phone (928) 763-8313

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Derek Price Chiropractic PLLC Chiropractor CurrentSince Apr 1, 2005 Accepting new patients
Kingman Chiropractic Clinic PC Chiropractor PastSince Jul 1, 2008 Accepting new patients

Locations

1868 Highway 95
Bullhead City, AZ 86442
Phone (928) 763-8313

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1023177672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2996 DESIERTO VERDE",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864295842",
            "telephone_number": "928-754-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 HIGHWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864426804",
            "telephone_number": "928-763-8313",
            "fax_number": "928-763-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "DEREK",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "5736",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.