Individual provider Active NPI

Thomas Edward Deebel, D.C.

  • Chiropractor
  • Shenandoah, PA
National Provider Identifier
1215088729
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC3836L Issued in PA
Practice address
110 N Main St
Shenandoah, PA 17976-1743
Phone
(570) 462-3522
Fax
(570) 462-3523
NPI assigned
Jan 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC3836L PA Primary

Addresses

Primary practice location

110 N Main St
Shenandoah, PA 17976-1743

Mailing address

110 N Main St
Shenandoah, PA 17976-1743
Phone (570) 462-3522

Other identifiers 1

IdentifierTypeStateIssuer
0011462330002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000148 PA Practitioner - Chiropractic 5395911945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 N Main St
Shenandoah, PA 17976-1743
Phone (570) 462-3522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC3836LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Deebel Chiropractic Clinic P.C. Chiropractor CurrentSince Sep 19, 2011 Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215088729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N MAIN ST",
            "city": "SHENANDOAH",
            "state": "PA",
            "postal_code": "179761743",
            "telephone_number": "570-462-3522",
            "fax_number": "570-462-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N MAIN ST",
            "city": "SHENANDOAH",
            "state": "PA",
            "postal_code": "179761743",
            "telephone_number": "570-462-3522",
            "fax_number": "570-462-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEBEL",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC3836L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011462330002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, PA

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.