Organization Active NPI

DC Family Chiropractic Inc

  • Chiropractor
  • Canon City, CO
National Provider Identifier
1174706261
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CO 4711 Issued in CO
Legal business name
DC FAMILY CHIROPRACTIC INC
Practice address
212 N 19TH St
Canon City, CO 81212-2423
Phone
(719) 275-4757
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Authorized official

Name
Dr. Dale Chris Buckhaults, DCNPI 1720050420
Title
President
Phone
(719) 275-4757

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 CO 4711 CO Primary

Addresses

Primary practice location

212 N 19TH St
Canon City, CO 81212-2423

Mailing address

212 N 19TH St
Canon City, CO 81212-2423
Phone (719) 275-4757

Other names 1

  • DC Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080131000209 CO Part B Supplier - Clinic/Group Practice 5890877799 Receives reassigned benefits from 1 practitioner
Practice locations: Canon City, CO

National Provider Directory

National Provider Directory

Locations

212 N 19th St
Canon City, CO 81212
Phone (714) 275-4757

Interoperability endpoints

  • Direct secure messaging: drdcb@dfc0015.direct.chirotouch.md

Practitioners & affiliated clinicians

Practitioners 1

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": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1174706261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N 19TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122423",
            "telephone_number": "719-275-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N 19TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122423",
            "telephone_number": "719-275-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DC FAMILY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "BUCKHAULTS",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "CHRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-275-4757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CO 4711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DC Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.