Organization Active NPI

Scott a Dubrul, Chiropractic Corporation

  • Chiropractor
  • San Luis Obispo, CA
National Provider Identifier
1083739841
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC22650 Issued in CA
Legal business name
SCOTT A DUBRUL, CHIROPRACTIC CORPORATION
Practice address
1422 Monterey St Ste A201
San Luis Obispo, CA 93401-2954
Phone
(805) 781-9155
Fax
(805) 781-0104
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Authorized official

Name
Julie Lynn Dubrul
Title
Office Manager
Phone
(805) 781-9155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC22650 CA Primary

Addresses

Primary practice location

1422 Monterey St Ste A201
San Luis Obispo, CA 93401-2954

Mailing address

1422 Monterey St Ste A201
San Luis Obispo, CA 93401-2954
Phone (805) 781-9155

Other identifiers 1

IdentifierTypeStateIssuer
570498505OtherCASS # & OLD TAX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060126000500 CA Part B Supplier - Clinic/Group Practice 5395759575 Receives reassigned benefits from 1 practitioner
Practice locations: San Luis Obispo, CA

National Provider Directory

National Provider Directory

Locations

1422 Monterey St
Ste A201
San Luis Obispo, CA 93401
Phone (760) 505-1662

1422 Monterey St
San Luis Obispo, CA 93401
Phone (805) 234-2127

Practitioners & affiliated clinicians

Practitioners 3

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1083739841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 MONTEREY ST STE A201",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012954",
            "telephone_number": "805-781-9155",
            "fax_number": "805-781-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 MONTEREY ST STE A201",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012954",
            "telephone_number": "805-781-9155",
            "fax_number": "805-781-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT A DUBRUL, CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "DUBRUL",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "805-781-9155"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC22650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SS # & OLD TAX",
            "identifier": "570498505",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.