NPIMap

Organization Active NPI

Bryn Mawr Wellness LLC

  • Chiropractor
  • Bryn Mawr, PA
National Provider Identifier
1023358918
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BRYN MAWR WELLNESS LLC
Practice address
937 E Haverford Rd
Suite 101
Bryn Mawr, PA 19010-3800
Phone
(610) 520-2490
Fax
(610) 520-2492
NPI assigned
Feb 28, 2013
Last updated
Feb 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Dr. Jonathan C Crooker, DCNPI 1114096211
Title
President
Phone
(610) 520-2490

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
Chiropractor 111N00000X Primary

Addresses

Primary practice location

937 E Haverford Rd
Suite 101
Bryn Mawr, PA 19010-3800

Mailing address

937 E Haverford Rd
Suite 101
Bryn Mawr, PA 19010-3800
Phone (610) 520-2490

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130411000199 PA Part B Supplier - Clinic/Group Practice 9335385657 Receives reassigned benefits from 1 practitioner
Practice locations: Bryn Mawr, PA

National Provider Directory

National Provider Directory

Locations

937 E Haverford Rd
Ste 101
Bryn Mawr, PA 19010
Phone (610) 520-2490

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1023358918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 E HAVERFORD RD",
            "address_2": "SUITE 101",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103800",
            "telephone_number": "610-520-2490",
            "fax_number": "610-520-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 E HAVERFORD RD",
            "address_2": "SUITE 101",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103800",
            "telephone_number": "610-520-2490",
            "fax_number": "610-520-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYN MAWR WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "CROOKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-520-2490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.