NPIMap

Organization Active NPI

Waldoboro Chiropractic Center PA

  • Chiropractor
  • Waldoboro, ME
National Provider Identifier
1053487702
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR875 Issued in ME
Legal business name
WALDOBORO CHIROPRACTIC CENTER PA
Practice address
290 Bremen Rd
Waldoboro, ME 04572-0625
Phone
(207) 832-6347
Fax
(207) 832-4664
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Authorized official

Name
Jennifer Harvey
Title
Manager
Phone
(207) 832-6347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CR875 ME Primary

Addresses

Primary practice location

290 Bremen Rd
Waldoboro, ME 04572-0625

Mailing address

PO Box 625
Waldoboro, ME 04572-0625
Phone (207) 832-6347

Other identifiers 2

IdentifierTypeStateIssuer
129130100MedicaidME
022301OtherANTHEM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1053487702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 625",
            "city": "WALDOBORO",
            "state": "ME",
            "postal_code": "045720625",
            "telephone_number": "207-832-6347",
            "fax_number": "207-832-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 BREMEN RD",
            "city": "WALDOBORO",
            "state": "ME",
            "postal_code": "045720625",
            "telephone_number": "207-832-6347",
            "fax_number": "207-832-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDOBORO CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "207-832-6347"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129130100",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "022301",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldoboro, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.