Organization Active NPI

Healing Ways PLLC

Doing business as San Pedro chiropractic

  • Chiropractor
  • Benson, AZ
National Provider Identifier
1124532361
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4956 Issued in AZ
Legal business name
HEALING WAYS PLLC
Doing business as
San Pedro chiropractic
Practice address
338 E 4TH St
Benson, AZ 85602
Phone
(520) 586-9364
NPI assigned
Nov 27, 2017
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Dr. Frederick Von Brinck Ways PLLC, DC
Title
Member
Phone
(520) 586-9364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4956 AZ Primary

Addresses

Primary practice location

338 E 4TH St
Benson, AZ 85602

Mailing address

338 E 4TH St
Benson, AZ 85602-6614

Other names 1

  • San Pedro chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171207000590 AZ Part B Supplier - Clinic/Group Practice 3971860560 Receives reassigned benefits from 1 practitioner
Practice locations: Benson, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1511740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1124532361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 E 4TH ST",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "856026614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 E 4TH ST",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "85602",
            "telephone_number": "520-586-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING WAYS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-27",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "PLLC",
        "authorized_official_first_name": "FREDERICK VON BRINCK",
        "authorized_official_middle_name": "WAYS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "520-586-9364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "4956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Pedro chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.