Individual provider Active NPI

Dwight David Schaefer, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1093859837
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3436 Issued in AZ
Practice address
15610 N 35TH Ave
Ste 11
Phoenix, AZ 85053-3838
Phone
(602) 548-6100
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3436 AZ Primary

Addresses

Primary practice location

15610 N 35TH Ave
Ste 11
Phoenix, AZ 85053-3838

Mailing address

15610 N 35TH Ave
Ste 11
Phoenix, AZ 85053-3838
Phone (602) 548-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3436AZMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1093859837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15610 N 35TH AVE",
            "address_2": "STE 11",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850533838",
            "telephone_number": "602-548-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15610 N 35TH AVE",
            "address_2": "STE 11",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850533838",
            "telephone_number": "602-548-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "DWIGHT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "3436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.