Organization Active NPI

Pacific Chiropractic, Inc

  • Chiropractor
  • Kihei, HI
National Provider Identifier
1124492673
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PACIFIC CHIROPRACTIC, INC
Practice address
310 Ohukai Rd Ste 312
Kihei, HI 96753-7061
Phone
(808) 871-7745
Fax
(808) 874-1802
NPI assigned
Nov 20, 2015
Last updated
Nov 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Dr. John E. Avallone Jr., D.C.NPI 1639211279
Title
President
Phone
(808) 871-7745

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 Primary

Addresses

Primary practice location

310 Ohukai Rd Ste 312
Kihei, HI 96753-7061

Mailing address

310 Ohukai Rd Ste 312
Kihei, HI 96753-7061
Phone (808) 871-7745

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160129001031 HI Part B Supplier - Clinic/Group Practice 3971806613 Receives reassigned benefits from 1 practitioner
Practice locations: Kihei, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1124492673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 OHUKAI RD STE 312",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537061",
            "telephone_number": "808-871-7745",
            "fax_number": "808-874-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 OHUKAI RD STE 312",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537061",
            "telephone_number": "808-871-7745",
            "fax_number": "808-874-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "AVALLONE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-871-7745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.