NPIMap

Organization Active NPI

Family Tree Chiropractic, LLC

  • Chiropractor
  • Ephrata, PA
National Provider Identifier
1275837387
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC003403L Issued in PA
Legal business name
FAMILY TREE CHIROPRACTIC, LLC
Practice address
904 Dawn Ave
Ephrata, PA 17522-1340
Phone
(717) 738-2555
Fax
(717) 738-2557
NPI assigned
Jan 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Authorized official

Name
Dr. David S Parker, D.C.NPI 1457471203
Title
President
Phone
(717) 738-2555

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC003403L PA Primary
Pediatric ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NP0017X DC003403L PA
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X
Occupational Health ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0100X DC003403L PA

Addresses

Primary practice location

904 Dawn Ave
Ephrata, PA 17522-1340

Mailing address

904 Dawn Ave
Ephrata, PA 17522-1340
Phone (717) 738-2555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150521001614 PA Part B Supplier - Clinic/Group Practice 7012237696 Receives reassigned benefits from 1 practitioner
Practice locations: Ephrata, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2265112Family Tree Chiropractic904 Dawn Avenue, Ephrata, PA 17522Certificate of waiverJul 21, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1275837387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 DAWN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221340",
            "telephone_number": "717-738-2555",
            "fax_number": "717-738-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 DAWN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221340",
            "telephone_number": "717-738-2555",
            "fax_number": "717-738-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY TREE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-738-2555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC003403L",
            "primary": true
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "PA",
            "license": "DC003403L",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": "PA",
            "license": "DC003403L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.