Individual provider Active NPI

Robert W Daniels Jr., DC

  • Chiropractor
  • Claysville, PA
National Provider Identifier
1104875665
Registry record updated Oct 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007657-L Issued in PA
Practice address
231 Main Street
Claysville, PA 15323
Phone
(724) 663-4255
Fax
(724) 663-4256
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC007657-L PA Primary

Addresses

Primary practice location

231 Main Street
Claysville, PA 15323

Mailing address

231 Main Street
Claysville, PA 15323
Phone (724) 663-4255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060727000328 PA Practitioner - Chiropractic 8224041835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Burgman Chiropractic ClinicGroup PAC ID 8224283601, 2 clinicians

Practice addresses (Care Compare)

4050 Washington Rd
Suite 5C
MC Murray, PA 15317-2543
Phone (724) 941-1366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DC007657-LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Burgman Chiropractic Clinic Chiropractor CurrentSince Jun 17, 2024 Accepting new patients

Locations

4050 Washington Rd
Ste 5C
McMurray, PA 15317
Phone (724) 941-1366

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507420800000",
    "number": "1104875665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAIN STREET",
            "city": "CLAYSVILLE",
            "state": "PA",
            "postal_code": "15323",
            "telephone_number": "724-663-4255",
            "fax_number": "724-663-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 MAIN STREET",
            "city": "CLAYSVILLE",
            "state": "PA",
            "postal_code": "15323",
            "telephone_number": "724-663-4255",
            "fax_number": "724-663-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2017-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007657-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claysville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.