Organization Active NPI

Brodheadsville Chiropractic

  • Chiropractor
  • Brodheadsville, PA
National Provider Identifier
1124023114
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC1730L Issued in PA
Legal business name
BRODHEADSVILLE CHIROPRACTIC
Practice address
6 Pilgrim Way
Brodheadsville, PA 18322-0447
Phone
(570) 992-7626
Fax
(570) 992-8759
NPI assigned
Jun 16, 2005
Organization subpart
Yes
Parent organization
BRODHEADSVILLE CHIROPRACTICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Authorized official

Name
Dr. Robert John Van Metter, DCNPI 1497750483
Title
Owner Chiropractic
Phone
(570) 992-7626

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC1730L PA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X

Addresses

Primary practice location

6 Pilgrim Way
Brodheadsville, PA 18322-0447

Mailing address

PO Box 447
6 Pilgrim Way
Brodheadsville, PA 18322-0447
Phone (570) 992-7626

Other names 1

  • Robert J Van Metter Other name

National Provider Directory

National Provider Directory
Part of
Brodheadsville Chiropractic

Locations

134 Pilgrim Way
Brodheadsvlle, PA 18322
Phone (570) 992-7626

Practitioners & affiliated clinicians

Practitioners 2

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": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1124023114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "address_2": "6 PILGRIM WAY",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183220447",
            "telephone_number": "570-992-7626",
            "fax_number": "570-992-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PILGRIM WAY",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183220447",
            "telephone_number": "570-992-7626",
            "fax_number": "570-992-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRODHEADSVILLE CHIROPRACTIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRODHEADSVILLE CHIROPRACTIC",
        "enumeration_date": "2005-06-16",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "VAN METTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER CHIROPRACTIC",
        "authorized_official_telephone_number": "570-992-7626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC1730L",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert J Van Metter",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brodheadsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.