Optimum Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

8620 Issued in AZ

Legal business name

OPTIMUM CHIROPRACTIC PLLC

Practice address

8765 W Kelton LN
B-4 Suite 150
Peoria, AZ 85382-3584

Phone

(623) 979-7100

Fax

(623) 979-3577

NPI assigned

Mar 28, 2017

Organization subpart

No

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

Authorized official

Name

Timothy Scott Ballitch, D.C.

Title

Owner

Phone

(623) 979-7100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1114459492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 W KELTON LN",
            "address_2": "B-4 SUITE 150",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823584",
            "telephone_number": "623-979-7100",
            "fax_number": "623-979-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 W KELTON LN",
            "address_2": "B-4 SUITE 150",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823584",
            "telephone_number": "623-979-7100",
            "fax_number": "623-979-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "BALLITCH",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-979-7100",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.