5TH Avenue Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC010105 Issued in PA

Legal business name

5TH AVENUE CHIROPRACTIC

Practice address

761 5TH Ave
Suite F
Chambersburg, PA 17201-4210

Phone

(717) 263-6101

Fax

(717) 263-6202

NPI assigned

Sep 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Bryan C Staker, D.C.NPI 1205068426

Title

Owner

Phone

(630) 240-9084

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan Curtus Staker, D.C.

  • Chiropractor
  • Chambersburg, PA
  • NPI 1205068426
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1154655660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 5TH AVE",
            "address_2": "SUITE F",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014210",
            "telephone_number": "717-263-6101",
            "fax_number": "717-263-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 5TH AVE",
            "address_2": "SUITE F",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014210",
            "telephone_number": "717-263-6101",
            "fax_number": "717-263-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5TH AVENUE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "STAKER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-240-9084",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Chambersburg, PA
• Providers in Chambersburg, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.