Organization Active NPI

Cowell Chiropractic Inc

  • Chiropractor
  • Fortuna, CA
National Provider Identifier
1093475709
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
COWELL CHIROPRACTIC INC
Practice address
431 N Fortuna Blvd
Fortuna, CA 95540-2724
Phone
(707) 726-9179
Fax
(707) 726-9185
NPI assigned
Dec 21, 2021
Last updated
May 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Authorized official

Name
Mrs. Jacquita M Terrell
Title
Office Manager
Phone
(707) 923-2880

Specialties & licenses 1

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

Addresses

Primary practice location

431 N Fortuna Blvd
Fortuna, CA 95540-2724

Mailing address

431 N Fortuna Blvd
Fortuna, CA 95540-2724
Phone (707) 726-9179

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220310001055 CA Part B Supplier - Clinic/Group Practice 4284029257 Receives reassigned benefits from 1 practitioner
Practice locations: Fortuna, CA

National Provider Directory

National Provider Directory

Locations

431 N Fortuna Blvd
Fortuna, CA 95540
Phone (707) 726-9179

Practitioners & affiliated clinicians

Practitioners 2

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": "1640044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1093475709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 N FORTUNA BLVD",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955402724",
            "telephone_number": "707-726-9179",
            "fax_number": "707-726-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 N FORTUNA BLVD",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955402724",
            "telephone_number": "707-726-9179",
            "fax_number": "707-726-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COWELL CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-21",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "TERRELL",
        "authorized_official_first_name": "JACQUITA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "707-923-2880",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fortuna, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.