Active NPI
Ti Robert-Vernon Pence, D.C.
- Chiropractor
- Stanford, CA
National Provider Identifier
1194804682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 30614
- Practice address
- 300 Pasteur Dr
Stanford, CA 94305-2200 - Phone
- (650) 723-4000
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC-30614 | CA | |
| Chiropractor | 111N00000X | 5905 | CO | |
| Sports Physician Chiropractor | 111NS0005X | 30614 | CA | |
| Chiropractor | 111N00000X | 30614 | CA | Primary |
Addresses
Primary practice location
300 Pasteur Dr
Stanford, CA 94305-2200
Mailing address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000
Other practice location 1
409 Alberto Way Ste 3
Los Gatos, CA 95032-5407
Phone (408) 827-1422
Other names 1
- Dr. Robert Vernon Pence
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5905 | CO | MD | Professional Counselor |
| DC-30614 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chirofit Enterprises LLC | Chiropractor | Current | Accepting new patients |
Locations
2115 Green Vista Dr
Ste 103
Sparks, NV 89431
Phone (775) 409-3274
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Sparks, NV
- NPI 1205426095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674691200000",
"number": "1194804682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
}
],
"practiceLocations": [
{
"address_1": "409 Alberto Way Ste 3",
"address_purpose": "LOCATION",
"city": "Los Gatos",
"state": "CA",
"postal_code": "950325407",
"country_code": "US",
"telephone_number": "408-827-1422",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PENCE",
"first_name": "TI",
"middle_name": "ROBERT-VERNON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2023-01-26",
"certification_date": "2023-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC-30614",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "5905",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "CA",
"license": "30614",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "30614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ROBERT",
"last_name": "PENCE",
"middle_name": "VERNON",
"prefix": "DR.",
"credential": "DC",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.