Organization Active NPI

Spinal Care Chiropractic and Joint Rehabilitation, P.C.

  • Chiropractor
  • Collegeville, PA
National Provider Identifier
1124419767
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC009896 Issued in PA
Legal business name
SPINAL CARE CHIROPRACTIC AND JOINT REHABILITATION, P.C.
Practice address
109 Second Ave
Collegeville, PA 19426-2608
Phone
(386) 562-1269
Fax
(610) 489-8821
NPI assigned
Feb 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Authorized official

Name
Dr. Kristen Ann Walters, D.C.NPI 1497930564
Title
Owner/Doctos
Phone
(386) 562-1269

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 DC009896 PA Primary

Addresses

Primary practice location

109 Second Ave
Collegeville, PA 19426-2608

Mailing address

109 Second Ave
Collegeville, PA 19426-2608
Phone (386) 562-1269

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150601001841 PA Part B Supplier - Clinic/Group Practice 6709107881 Receives reassigned benefits from 1 practitioner
Practice locations: Collegeville, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1124419767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SECOND AVE",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262608",
            "telephone_number": "386-562-1269",
            "fax_number": "610-489-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SECOND AVE",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262608",
            "telephone_number": "386-562-1269",
            "fax_number": "610-489-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL CARE CHIROPRACTIC AND JOINT REHABILITATION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/DOCTOS",
        "authorized_official_telephone_number": "386-562-1269",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.