Individual provider Active NPI

Cynthia A Tomchak Long, DC

  • Chiropractor
  • Chandler, AZ
National Provider Identifier
1114051174
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6004 Issued in AZ
Practice address
2051 W Warner Rd
#1
Chandler, AZ 85224-2100
Phone
(480) 963-0504
Fax
(480) 963-2899
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6004 AZ Primary

Addresses

Primary practice location

2051 W Warner Rd
#1
Chandler, AZ 85224-2100

Mailing address

2051 W Warner Rd
#1
Chandler, AZ 85224-2100
Phone (480) 963-0504

Other names 1

  • Dr. Cynthia A Tomchak Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000981 AZ Practitioner - Chiropractic 0244125474 Practice locations: Chandler, AZ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6004AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back on Track Chiropractic Chiropractor 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1114051174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 W WARNER RD",
            "address_2": "#1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242100",
            "telephone_number": "480-963-0504",
            "fax_number": "480-963-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 W WARNER RD",
            "address_2": "#1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242100",
            "telephone_number": "480-963-0504",
            "fax_number": "480-963-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCHAK LONG",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "TOMCHAK",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.