Individual provider Active NPI

Bill Adams, DC, DACBR

  • Radiology Chiropractor
  • Erie, PA
National Provider Identifier
1104830330
Registry record updated Jul 8, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jan 19, 2011.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
License
DC-007794L Issued in PA
Practice address
6660 Peach St Unit 7 # 323
Erie, PA 16509-7718
Phone
(484) 634-6925
Fax
(866) 512-5215
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Chiropractor 111NR0200X DC-007794L PA Primary

Addresses

Primary practice location

6660 Peach St Unit 7 # 323
Erie, PA 16509-7718

Mailing address

6660 Peach St Unit 7 # 323
Erie, PA 16509-7718
Phone (484) 634-6925

Other identifiers 5

IdentifierTypeStateIssuer
0019504270002MedicaidPA
2574808OtherPAAETNA
433012ADAOtherPAUNITED HEALTHCARE
AD916544OtherPABLUE SHIELD
1038321OtherPAASHN/CAPITAL BLUE CROSS

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DC-007794LPAMDRadiology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Spine Centers 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104830330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6660 PEACH ST UNIT 7 # 323",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165097718",
            "telephone_number": "484-634-6925",
            "fax_number": "866-512-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6660 PEACH ST UNIT 7 # 323",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165097718",
            "telephone_number": "484-634-6925",
            "fax_number": "866-512-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "BILL",
        "name_prefix": "Dr.",
        "credential": "DC, DACBR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "PA",
            "license": "DC-007794L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019504270002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2574808",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "433012ADA",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "AD916544",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHN/CAPITAL BLUE CROSS",
            "identifier": "1038321",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.