Organization Active NPI

Live Movement Chiropractic & Wellness Clinic PSC

  • Chiropractor
  • Bayamon, PR
National Provider Identifier
1184147639
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
434 Issued in PR
Legal business name
LIVE MOVEMENT CHIROPRACTIC & WELLNESS CLINIC PSC
Practice address
Calle 24 Aa3
Flamboyan Gardens
Bayamon, PR 00959-5803
Phone
(787) 395-7555
Fax
(787) 395-7556
NPI assigned
Jul 17, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. John E Carreras Rodriguez, DCNPI 1215197363
Title
President
Phone
(787) 395-7555

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
Chiropractor 111N00000X 434 PR Primary

Addresses

Primary practice location

Calle 24 Aa3
Flamboyan Gardens
Bayamon, PR 00959-5803

Mailing address

Aa3 Calle 24
Urb Flamboyan GDNS
Bayamon, PR 00959-5803
Phone (787) 395-7555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190531000681 PR Part B Supplier - Clinic/Group Practice 3375876600 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Locations

AA3 Calle 24
Bayamon, PR 00959
Phone (787) 395-7555

Practitioners & affiliated clinicians

Practitioners 1

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": "1500249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1184147639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AA3 CALLE 24",
            "address_2": "URB FLAMBOYAN GDNS",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595803",
            "telephone_number": "787-395-7555",
            "fax_number": "787-395-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 24 AA3",
            "address_2": "FLAMBOYAN GARDENS",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595803",
            "telephone_number": "787-395-7555",
            "fax_number": "787-395-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE MOVEMENT CHIROPRACTIC & WELLNESS CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CARRERAS RODRIGUEZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-395-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.