NPIMap

Organization Active NPI

Anderson Chiropractic, PC

Doing business as Anderson Family Chiropractic

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1104684976
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ANDERSON CHIROPRACTIC, PC
Doing business as
Anderson Family Chiropractic
Practice address
4127 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Phone
(505) 308-8885
Fax
(505) 308-8886
NPI assigned
Mar 7, 2024
Last updated
Jul 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
Dr. Taylor Alexis Blackford Anderson, DCNPI 1346993276
Title
Owner/Chiropractor
Phone
(515) 822-7319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

4127 Montgomery Blvd NE
Albuquerque, NM 87109-1102

Mailing address

4579 La Madera Rd
Sandia Park, NM 87047-9399
Phone (515) 822-7319

Other practice location 1

1942 Old US 66 Ste B
Edgewood, NM 87015-6745
Phone (505) 715-4705

Other names 2

  • Anderson Family Chiropractic Doing business as
  • Anderson Family Chiropractic of ABQ LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240826000159 NM Part B Supplier - Clinic/Group Practice 1759820574 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Albuquerque, NM; Edgewood, NM

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Anderson Chiropractic PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1942 Old US 66
Edgewood, NM 87015

Practitioners & affiliated clinicians

Practitioners 3

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": "1709769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1104684976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 LA MADERA RD",
            "city": "SANDIA PARK",
            "state": "NM",
            "postal_code": "870479399",
            "telephone_number": "515-822-7319",
            "fax_number": "505-308-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4127 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091102",
            "telephone_number": "505-308-8885",
            "fax_number": "505-308-8886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1942 Old US 66 Ste B",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "NM",
            "postal_code": "870156745",
            "country_code": "US",
            "telephone_number": "505-715-4705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDERSON CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_middle_name": "ALEXIS BLACKFORD",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "515-822-7319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anderson Family Chiropractic of ABQ LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.