Mendonca Chiropractic – Chiropractor in Revere, MA

Key facts

NPI: 1164570925
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
License: 3086 (MA)
Legal business name: MENDONCA CHIROPRACTIC
Practice address: 344 Broadway
Revere, MA 02151-5016
Phone: (503) 449-9745
NPI assigned: Jan 8, 2007
Organization subpart: No

Authorized official

Name: Luis M Mendonca, DC NPI 1144338013
Title: Owner
Phone: (503) 449-9745

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

Luis M Mendonca Chiropractor · Revere, MA · NPI 1144338013

NPD (past) Authorized official CHIROPRACTOR

National Provider Directory

Locations

344 Broadway
Revere, MA 02151
Phone (503) 449-9745

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193400000X SINGLE SPECIALTY GROUP	111N00000X	3086	MA	Yes

Addresses

Primary practice location

344 Broadway
Revere, MA 02151-5016

Mailing address

171 Bristol Ave
Pawtucket, RI 02861-2240
Phone (503) 449-9745

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164570925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 BRISTOL AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028612240",
            "telephone_number": "503-449-9745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515016",
            "telephone_number": "503-449-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDONCA CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MENDONCA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-449-9745",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

All providers in Revere, MA · Chiropractor in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.