NPIMap

Organization Active NPI

Legnola and Marcussen Chiropractic Associates

  • Chiropractor
  • Blue Bell, PA
National Provider Identifier
1174565717
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006991L Issued in PA
Legal business name
LEGNOLA AND MARCUSSEN CHIROPRACTIC ASSOCIATES
Practice address
1717 Swede Road
Suite 106
Blue Bell, PA 19422
Phone
(484) 688-0664
Fax
(484) 688-0667
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kristin L Marcussen, DC
Title
Partner
Phone
(484) 688-0664

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC006991L PA Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC006990L PA

Addresses

Primary practice location

1717 Swede Road
Suite 106
Blue Bell, PA 19422

Mailing address

1717 Swede Road
Suite 106
Blue Bell, PA 19422
Phone (484) 688-0664

Other identifiers 2

IdentifierTypeStateIssuer
2130234000OtherINDEP BC
2130234000OtherHMO INDEP BC

Other names 1

  • Community Chiropractic Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050802001099 PA Part B Supplier - Clinic/Group Practice 6406884204 Receives reassigned benefits from 3 practitioners
Practice locations: Blue Bell, PA; Lower Gwynedd, PA

National Provider Directory

National Provider Directory

Locations

1717 Swede Rd
Ste 106
Blue Bell, PA 19422
Phone (484) 688-0664

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174565717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 SWEDE ROAD",
            "address_2": "SUITE 106",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "19422",
            "telephone_number": "484-688-0664",
            "fax_number": "484-688-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SWEDE ROAD",
            "address_2": "SUITE 106",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "19422",
            "telephone_number": "484-688-0664",
            "fax_number": "484-688-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGNOLA AND MARCUSSEN CHIROPRACTIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARCUSSEN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "484-688-0664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006991L",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006990L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEP BC",
            "identifier": "2130234000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO INDEP BC",
            "identifier": "2130234000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Bell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.