NPIMap

Organization Active NPI

Premier Chiropractic and Rehab

  • Rehabilitation Chiropractor
  • Metairie, LA
National Provider Identifier
1285035824
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
1676 Issued in LA
Legal business name
PREMIER CHIROPRACTIC AND REHAB
Practice address
3440 Division St
Suite G
Metairie, LA 70002-8606
Phone
(504) 456-8560
NPI assigned
Sep 15, 2014
Last updated
Dec 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Authorized official

Name
Dr. Shane M Henry, D.C.NPI 1285042515
Title
Chiropractor
Phone
(504) 456-8560

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: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 1676 LA Primary

Addresses

Primary practice location

3440 Division St
Suite G
Metairie, LA 70002-8606

Mailing address

3440 Division St
Suite G
Metairie, LA 70002-8606
Phone (985) 226-0984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151209000583 LA Part B Supplier - Clinic/Group Practice 6901107325 Receives reassigned benefits from 1 practitioner
Practice locations: Metairie, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1285035824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 DIVISION ST",
            "address_2": "SUITE G",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700028606",
            "telephone_number": "985-226-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 DIVISION ST",
            "address_2": "SUITE G",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700028606",
            "telephone_number": "504-456-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CHIROPRACTIC AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "504-456-8560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "LA",
            "license": "1676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.