Active NPI
Maria Lyn C Poulson, DC
- Chiropractor
- Phoenix, AZ
National Provider Identifier
1104097070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 7677
- Practice address
- 2040 E Bell Rd Ste 140
Phoenix, AZ 85022-2937 - Phone
- (602) 788-3159
- Fax
- (602) 788-0501
- NPI assigned
- Mar 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 7677 | AZ | Primary |
Addresses
Primary practice location
2040 E Bell Rd Ste 140
Phoenix, AZ 85022-2937
Mailing address
2040 E Bell Rd Ste 140
Phoenix, AZ 85022-2937
Phone (602) 788-3159
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7677 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Chiropractic, P.C. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Glendale, AZ
- NPI 1346391737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205798400000",
"number": "1104097070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 E BELL RD STE 140",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850222937",
"telephone_number": "602-788-3159",
"fax_number": "602-788-0501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 E BELL RD STE 140",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850222937",
"telephone_number": "602-788-3159",
"fax_number": "602-788-0501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULSON",
"first_name": "MARIA LYN",
"middle_name": "C",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-18",
"last_updated": "2008-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "7677",
"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 Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.