NPIMap

Organization Active NPI

Breaking Boundaries Wellness Center, LLC

  • Chiropractor
  • Philadelphia, PA
National Provider Identifier
1043554546
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC010296 Issued in PA
Legal business name
BREAKING BOUNDARIES WELLNESS CENTER, LLC
Practice address
836 North 3Rd St.
Suite 2
Philadelphia, PA 19123
Phone
(215) 964-9947
Fax
(215) 964-9655
NPI assigned
Nov 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Authorized official

Name
Tasha PowellNPI 1821303017
Title
Dr.
Phone
(215) 964-9947

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 DC010296 PA Primary

Addresses

Primary practice location

836 North 3Rd St.
Suite 2
Philadelphia, PA 19123

Mailing address

836 North 3Rd St.
Suite 2
Philadelphia, PA 19123
Phone (215) 964-9947

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1353456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1043554546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 NORTH 3RD ST.",
            "address_2": "SUITE 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19123",
            "telephone_number": "215-964-9947",
            "fax_number": "215-964-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 NORTH 3RD ST.",
            "address_2": "SUITE 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19123",
            "telephone_number": "215-964-9947",
            "fax_number": "215-964-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKING BOUNDARIES WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "TASHA",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "215-964-9947"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.