Organization Active NPI

Lehigh Valley Spinal Care Center

  • Rehabilitation Chiropractor
  • Walnutport, PA
National Provider Identifier
1275666232
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC007463L Issued in PA
Legal business name
LEHIGH VALLEY SPINAL CARE CENTER
Practice address
4450 W Mountain View Dr
Walnutport, PA 18088-9429
Phone
(610) 767-8888
Fax
(610) 760-8965
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Authorized official

Name
Dr. Ross Buchieri, DCNPI 1659390128
Title
Owner
Phone
(610) 760-8888

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
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X DC007463L PA Primary

Addresses

Primary practice location

4450 W Mountain View Dr
Walnutport, PA 18088-9429

Mailing address

4450 W Mountain View Dr
Walnutport, PA 18088-9429
Phone (610) 767-8888

Other identifiers 2

IdentifierTypeStateIssuer
1659390128OtherPAINDIVIDUAL NPI
01734709MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091012000065 PA Part B Supplier - Clinic/Group Practice 6608912308 Receives reassigned benefits from 1 practitioner
Practice locations: Walnutport, PA

National Provider Directory

National Provider Directory

Locations

4450 W Mountain View Dr
Walnutport, PA 18088
Phone (610) 760-8888

Practitioners & affiliated clinicians

Practitioners 1

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": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1275666232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 W MOUNTAIN VIEW DR",
            "city": "WALNUTPORT",
            "state": "PA",
            "postal_code": "180889429",
            "telephone_number": "610-767-8888",
            "fax_number": "610-760-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 W MOUNTAIN VIEW DR",
            "city": "WALNUTPORT",
            "state": "PA",
            "postal_code": "180889429",
            "telephone_number": "610-767-8888",
            "fax_number": "610-760-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEHIGH VALLEY SPINAL CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "BUCHIERI",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-760-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC007463L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1659390128",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01734709",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnutport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.