Organization Active NPI

Delmarva Chiropractic, P.C.

  • Chiropractor
  • Salisbury, MD
National Provider Identifier
1205987682
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03401 Issued in MD
Legal business name
DELMARVA CHIROPRACTIC, P.C.
Practice address
1324 Belmont Ave
Suite 102
Salisbury, MD 21804-4543
Phone
(410) 219-5155
Fax
(410) 219-3579
NPI assigned
Jan 14, 2007
Last updated
Aug 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Ms. Kristin M Fawber, B.A.
Title
Office Manager
Phone
(410) 219-5155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03401 MD Primary

Addresses

Primary practice location

1324 Belmont Ave
Suite 102
Salisbury, MD 21804-4543

Mailing address

1324 Belmont Ave
Suite 102
Salisbury, MD 21804-4543
Phone (410) 219-5155

Other identifiers 2

IdentifierTypeStateIssuer
1366555302OtherMDDR LANE'S NPI
1194894295OtherMDDR BROWN'S NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070305000159 MD Part B Supplier - Clinic/Group Practice 6608978085 Receives reassigned benefits from 3 practitioners
Practice locations: Salisbury, MD

National Provider Directory

National Provider Directory

Locations

1324 Belmont Ave
Salisbury, MD 21804
Phone (410) 219-5155

306 Tilghman Rd
Salisbury, MD 21804
Phone (410) 219-5155

Practitioners & affiliated clinicians

Practitioners 4

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": "1168732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1205987682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 BELMONT AVE",
            "address_2": "SUITE 102",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044543",
            "telephone_number": "410-219-5155",
            "fax_number": "410-219-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 BELMONT AVE",
            "address_2": "SUITE 102",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044543",
            "telephone_number": "410-219-5155",
            "fax_number": "410-219-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELMARVA CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "FAWBER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-219-5155",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR LANE'S NPI",
            "identifier": "1366555302",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR BROWN'S NPI",
            "identifier": "1194894295",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.