Organization Active NPI

Valley Chiropractic Clinic, Inc

  • Chiropractor
  • Wasilla, AK
National Provider Identifier
1104913359
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AA187 Issued in AK
Legal business name
VALLEY CHIROPRACTIC CLINIC, INC
Practice address
400 N Main St
Wasilla, AK 99654-7018
Phone
(907) 373-2022
Fax
(907) 373-2029
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Dr. James Martin, D.C., C.C.S.P.NPI 1396724951
Title
President
Phone
(907) 373-2022

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X AA187 AK Primary

Addresses

Primary practice location

400 N Main St
Wasilla, AK 99654-7018

Mailing address

400 N Main St
Wasilla, AK 99654-7018
Phone (907) 373-2022

Other identifiers 1

IdentifierTypeStateIssuer
CH0065MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071015000315 AK Part B Supplier - Clinic/Group Practice 2860588381 Receives reassigned benefits from 2 practitioners
Practice locations: Wasilla, AK

National Provider Directory

National Provider Directory

Locations

400 N Main St
Wasilla, AK 99654
Phone (907) 373-2022

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1104913359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547018",
            "telephone_number": "907-373-2022",
            "fax_number": "907-373-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547018",
            "telephone_number": "907-373-2022",
            "fax_number": "907-373-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-373-2022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., C.C.S.P."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "AA187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0065",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.