NPIMap

Organization Active NPI

Donna M Copertino PC

Doing business as Back In Action Chiropractic Rehabilitation

  • Rehabilitation Chiropractor
  • Bath, PA
National Provider Identifier
1265508584
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC007080L Issued in PA
Legal business name
DONNA M COPERTINO PC
Doing business as
Back In Action Chiropractic Rehabilitation
Practice address
151 N Chestnut St
Bath, PA 18014-1138
Phone
(610) 837-8854
Fax
(610) 837-7884
NPI assigned
Nov 28, 2006
Last updated
Aug 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Authorized official

Name
Kim Poynor
Title
Office Manager
Phone
(610) 837-8854

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC007080L PA Primary

Addresses

Primary practice location

151 N Chestnut St
Bath, PA 18014-1138

Mailing address

151 N Chestnut St
Bath, PA 18014-1138
Phone (610) 837-8854

Other names 1

  • Back In Action Chiropractic Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040506000586 PA Part B Supplier - Clinic/Group Practice 9335137322 Receives reassigned benefits from 2 practitioners
Practice locations: Bath, PA

National Provider Directory

National Provider Directory

Locations

151 N Chestnut St
Bath, PA 18014
Phone (610) 837-8854

Practitioners & affiliated clinicians

Practitioners 6

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1265508584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N CHESTNUT ST",
            "city": "BATH",
            "state": "PA",
            "postal_code": "180141138",
            "telephone_number": "610-837-8854",
            "fax_number": "610-837-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N CHESTNUT ST",
            "city": "BATH",
            "state": "PA",
            "postal_code": "180141138",
            "telephone_number": "610-837-8854",
            "fax_number": "610-837-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA M COPERTINO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "POYNOR",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-837-8854"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC007080L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back In Action Chiropractic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bath, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.