Organization Active NPI

Cherry Street Chiropractic, LLC

  • Chiropractor
  • Danvers, MA
National Provider Identifier
1265798300
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHERRY STREET CHIROPRACTIC, LLC
Practice address
15 Cherry St
Danvers, MA 01923-2880
Phone
(978) 774-4468
Fax
(978) 225-0951
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Dr. William R Nolan Jr., D.C.NPI 1316900426
Title
Owner
Phone
(978) 774-4468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X MA Primary

Addresses

Primary practice location

15 Cherry St
Danvers, MA 01923-2880

Mailing address

15 Cherry St
Danvers, MA 01923-2880
Phone (978) 774-4468

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120531000138 MA Part B Supplier - Clinic/Group Practice 2466615489 Receives reassigned benefits from 1 practitioner
Practice locations: Danvers, MA

National Provider Directory

National Provider Directory

Locations

140 Commonwealth Ave
Ste 208B
Danvers, MA 01923
Phone (978) 774-4468

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1265798300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CHERRY ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232880",
            "telephone_number": "978-774-4468",
            "fax_number": "978-225-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CHERRY ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232880",
            "telephone_number": "978-774-4468",
            "fax_number": "978-225-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY STREET CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-774-4468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.