Active NPI
Basil Eugene Pearson, D.C.
- Chiropractor
- Canon City, CO
National Provider Identifier
1215056577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1174
- Practice address
- 1311 S 9TH St
Canon City, CO 81212-4207 - Phone
- (719) 275-1611
- Fax
- (719) 275-2226
- NPI assigned
- Mar 28, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1174 | CO | Primary |
Addresses
Primary practice location
1311 S 9TH St
Canon City, CO 81212-4207
Mailing address
PO Box 1717
1311 So. 9TH St.
Canon City, CO 81215-1717
Phone (719) 275-1611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1174 | CO | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215056577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1717",
"address_2": "1311 SO. 9TH ST.",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812151717",
"telephone_number": "719-275-1611",
"fax_number": "719-275-2226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 S 9TH ST",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812124207",
"telephone_number": "719-275-1611",
"fax_number": "719-275-2226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "BASIL",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "1174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.