NPIMap

Organization Active NPI

Halberg Chiropractic Clinic, PLLC

Doing business as Halberg Chiropractic Clinic

  • Chiropractor
  • Port Angeles, WA
National Provider Identifier
1194778662
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034213 Issued in WA
Legal business name
HALBERG CHIROPRACTIC CLINIC, PLLC
Doing business as
Halberg Chiropractic Clinic
Practice address
430 E Lauridsen Blvd
Suite 113
Port Angeles, WA 98362-7978
Phone
(360) 457-7576
Fax
(360) 452-8079
NPI assigned
May 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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. James Gustaf Halberg, D.C.NPI 1548212624
Title
Member
Phone
(360) 457-7576

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 CH00034213 WA Primary

Addresses

Primary practice location

430 E Lauridsen Blvd
Suite 113
Port Angeles, WA 98362-7978

Mailing address

430 E Lauridsen Blvd
Suite 113
Port Angeles, WA 98362-7978
Phone (360) 457-7576

Other names 1

  • Halberg Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060626000317 WA Part B Supplier - Clinic/Group Practice 3274545728 Receives reassigned benefits from 1 practitioner
Practice locations: Port Angeles, WA

National Provider Directory

National Provider Directory

Locations

228 E Lauridsen Blvd
Port Angeles, WA 98362
Phone (360) 200-8744

430 E Lauridsen Blvd
Ste 113
Port Angeles, WA 98362
Phone (360) 457-7576

Practitioners & affiliated clinicians

Practitioners 7

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194778662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E LAURIDSEN BLVD",
            "address_2": "SUITE 113",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627978",
            "telephone_number": "360-457-7576",
            "fax_number": "360-452-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E LAURIDSEN BLVD",
            "address_2": "SUITE 113",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627978",
            "telephone_number": "360-457-7576",
            "fax_number": "360-452-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALBERG CHIROPRACTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALBERG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "GUSTAF",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "360-457-7576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halberg Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Angeles, WA

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.