Allison Chiropractic Center PC
Organization Active NPI Chiropractor · Derry, PA
NPI 1083199558 · NPPES record last updated Oct 1, 2018
Key facts
- NPI
- 1083199558
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- ALLISON CHIROPRACTIC CENTER PC
- Practice address
- 310 S Chestnut Street
Derry, PA 15627 - Phone
- (724) 694-9700
- NPI assigned
- Oct 1, 2018
- Organization subpart
- No
Authorized official
- Name
- Brianna Boliver, D.C.
- Title
- Owner
- Phone
- (724) 694-9700
Practitioners 4
-
Brianna Boliver, D.C.
-
Jared Elijah Allison, D.C.
-
Mathew Joseph Hahey, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190327002726 | PA | Part B Supplier - Clinic/Group Practice | 1951641018 |
Receives reassigned benefits from 2 practitioners Practice locations: Derry, PA |
National Provider Directory
Locations
310 S Chestnut St
Derry, PA 15627
Phone (724) 570-1389
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
310 S Chestnut Street
Derry, PA 15627
Mailing address
310 S Chestnut Street
Derry, PA 15627
Phone (724) 694-9700
NPI Registry JSON
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1538352000000",
"number": "1083199558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 S CHESTNUT STREET",
"city": "DERRY",
"state": "PA",
"postal_code": "15627",
"telephone_number": "724-694-9700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 S CHESTNUT STREET",
"city": "DERRY",
"state": "PA",
"postal_code": "15627",
"telephone_number": "724-694-9700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLISON CHIROPRACTIC CENTER PC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-01",
"last_updated": "2018-10-01",
"status": "A",
"authorized_official_last_name": "BOLIVER",
"authorized_official_first_name": "BRIANNA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "724-694-9700",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Derry, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.