Active NPI
Chiropractic Pain & Rehabilitation Center
- Rehabilitation Chiropractor
- Hagerstown, MD
National Provider Identifier
1194935874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- S01325
- Legal business name
- CHIROPRACTIC PAIN & REHABILITATION CENTER
- Practice address
- 1185 Mount Aetna Rd
Suite 102
Hagerstown, MD 21740-6832 - Phone
- (301) 739-0790
- Fax
- (301) 739-0353
- NPI assigned
- May 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Eric U Johnson, D.C.
- Title
- Sole Propritor
- Phone
- (301) 739-0790
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | S01325 | MD | Primary |
Addresses
Primary practice location
1185 Mount Aetna Rd
Suite 102
Hagerstown, MD 21740-6832
Mailing address
226 Venice Way
Shepherdstown, WV 25443-4648
Phone (304) 876-0500
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1017515 | Other | WV | BRICKSTREET |
| 609578 | Other | MD | ACN GROUP |
| M080 | Other | MD | CAREFIRST |
| 220619 | Other | MD | MAMSI OPTIMUM CHOICE ONE |
| 7946642 | Other | MD | CIGNA HEALTHCARE |
| 345287 | Other | MD | COVENTRY HEALTH |
| R155 | Other | MD | FEB |
| 095990 | Other | MD | US HEALTHCARE |
| 41578 | Other | MD | IWIF |
| 212092 | Other | MD | KAISER PERMANENTE |
| EJ1004587 | Other | MD | ASHN |
| R155001 | Other | MD | CAREFIRST BLUECHOICE |
| 4277955 | Other | MD | AETNA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Hagerstown, MD
- NPI 1912042250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1194935874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 VENICE WAY",
"city": "SHEPHERDSTOWN",
"state": "WV",
"postal_code": "254434648",
"telephone_number": "304-876-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1185 MOUNT AETNA RD",
"address_2": "SUITE 102",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217406832",
"telephone_number": "301-739-0790",
"fax_number": "301-739-0353"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHIROPRACTIC PAIN & REHABILITATION CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "ERIC",
"authorized_official_middle_name": "U",
"authorized_official_title_or_position": "SOLE PROPRITOR",
"authorized_official_telephone_number": "301-739-0790",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Rehabilitation",
"state": "MD",
"license": "S01325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BRICKSTREET",
"identifier": "1017515",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN GROUP",
"identifier": "609578",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "M080",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI OPTIMUM CHOICE ONE",
"identifier": "220619",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "7946642",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY HEALTH",
"identifier": "345287",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEB",
"identifier": "R155",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTHCARE",
"identifier": "095990",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IWIF",
"identifier": "41578",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER PERMANENTE",
"identifier": "212092",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHN",
"identifier": "EJ1004587",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BLUECHOICE",
"identifier": "R155001",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4277955",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.