Active NPI
Dennis L Poole, DC
- Chiropractor
- Orange, CA
National Provider Identifier
1114000692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 11019
- Practice address
- 1289 E Lincoln Ave
Orange, CA 92865-1910 - Phone
- (714) 282-6141
- Fax
- (714) 282-0513
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 11019 | CA | Primary |
Addresses
Primary practice location
1289 E Lincoln Ave
Orange, CA 92865-1910
Mailing address
1289 E Lincoln Ave
Orange, CA 92865-1910
Phone (714) 282-6141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110218000477 | CA | Practitioner - Chiropractic | 7618158080 | Practice locations: Orange, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11019 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280361600000",
"number": "1114000692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1289 E LINCOLN AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928651910",
"telephone_number": "714-282-6141",
"fax_number": "714-282-0513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1289 E LINCOLN AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928651910",
"telephone_number": "714-282-6141",
"fax_number": "714-282-0513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOLE",
"first_name": "DENNIS",
"middle_name": "L",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2010-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "11019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.