Edified Chiropractic Company LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EDIFIED CHIROPRACTIC COMPANY LLC

Practice address

1184 N Gilbert Rd Ste 200
Gilbert, AZ 85234-2476

Phone

(480) 903-8008

NPI assigned

Aug 18, 2022

Organization subpart

No

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

Authorized official

Name

Todd Beck, DC

Title

Owner

Phone

(208) 680-4246

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carson Reed Wilde, DC

  • Chiropractor
  • Gilbert, AZ
  • NPI 1265150908
  Medicare reassignment NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1255059994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 S HARPER",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852092423",
            "telephone_number": "480-903-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 N GILBERT RD STE 200",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342476",
            "telephone_number": "480-903-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDIFIED CHIROPRACTIC COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-680-4246",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "ChiroHD",
            "affiliation": "N",
            "endpointDescription": "Electronic Health Record Software",
            "address_1": "1184 N Gilbert Rd Ste 200",
            "city": "Gilbert",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852342476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jimmy D. Eddy, M.A.
• Ruth E Edeto-Malone
• Dylan Edgar
• Jillian Nicole Edgerly, CF-SLP
• Michael Wade Edgmon Jr., PHARM D
• Amanda Joy Edmond, PA-C
• Tateyana Edmond
• Allyson Edwards
• David Edwards, LPC
• David B Edwards, MD

• Clinic/Center in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.