Individual provider Active NPI

Patrick A Connolly, D.C.

  • Chiropractor
  • Altoona, PA
National Provider Identifier
1215900790
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC009462 Issued in PA
Practice address
1310 Valley View Blvd
Altoona, PA 16602-6080
Phone
(814) 944-2300
Fax
(814) 942-3455
NPI assigned
Feb 7, 2006
Last updated
Jul 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 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 DC009462 PA Primary

Addresses

Primary practice location

1310 Valley View Blvd
Altoona, PA 16602-6080

Mailing address

1310 Valley View Blvd
Altoona, PA 16602-6080
Phone (814) 944-2300

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC009462PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hofmeister Medical, PC Current Accepting new patients
Restore Health Medical Management Chiropractor Current Accepting new patients
Logan Valley Chiropractic Chiropractor Past Accepting new patients
Patrick Connolly, D.C., P.C. Chiropractor PastSince Sep 1, 2005 Accepting new patients

Locations

31682 Railroad Canyon Rd
Ste 6
Canyon Lake, CA 92587
Phone (951) 244-4040

31735 Riverside Dr
Ste K
Lake Elsinore, CA 92530
Phone (949) 629-3260

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1215900790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026080",
            "telephone_number": "814-944-2300",
            "fax_number": "814-942-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026080",
            "telephone_number": "814-944-2300",
            "fax_number": "814-942-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "PATRICK",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.

Verify at the official NPI Registry.