Organization Active NPI

Dover Chiropractic and Rehabilitation, Inc.

  • Rehabilitation Chiropractor
  • Dover, DE
National Provider Identifier
1053835926
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
F1-0000721 Issued in DE
Legal business name
DOVER CHIROPRACTIC AND REHABILITATION, INC.
Practice address
222 S Dupont Hwy Ste 203
Dover, DE 19901-3798
Phone
(302) 290-5552
Fax
(302) 376-6517
NPI assigned
Aug 1, 2017
Last updated
Apr 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Authorized official

Name
Dr. Trevor Kent Ennis, D.C.NPI 1316198005
Title
President
Phone
(302) 376-5830

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
Rehabilitation Chiropractor 111NR0400X F1-0000721 DE Primary

Addresses

Primary practice location

222 S Dupont Hwy Ste 203
Dover, DE 19901-3798

Mailing address

103 Ashvale Dr
Smyrna, DE 19977-4031
Phone (302) 290-5552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180208002027 DE Part B Supplier - Clinic/Group Practice 8022378249 Receives reassigned benefits from 10 practitioners
Practice locations: Dover, DE
O20260302001578 DE DME Supplier - Physician - Chiropractic 8022378249 Practice locations: Dover, DE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1501545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1053835926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 ASHVALE DR",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199774031",
            "telephone_number": "302-290-5552",
            "fax_number": "302-376-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S DUPONT HWY STE 203",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013798",
            "telephone_number": "302-290-5552",
            "fax_number": "302-376-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVER CHIROPRACTIC AND REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-01",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "ENNIS",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-376-5830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "DE",
            "license": "F1-0000721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.