NPIMap

Organization Active NPI

Core Chiropractic and Physical Therapy, LLC

  • Chiropractor
  • Millis, MA
National Provider Identifier
1295309953
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CORE CHIROPRACTIC AND PHYSICAL THERAPY, LLC
Practice address
969 Main St Ste 207
Millis, MA 02054-1555
Phone
(508) 918-2185
Fax
(508) 974-4467
NPI assigned
May 18, 2021
Last updated
Jun 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Authorized official

Name
Kelly Christine Cornell, DCNPI 1609113422
Title
Owner
Phone
(508) 918-2185

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

969 Main St Ste 207
Millis, MA 02054-1555

Mailing address

969 Main St Ste 207
Millis, MA 02054-1555
Phone (508) 918-2185

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210714001926 MA Part B Supplier - Clinic/Group Practice 7618379553 Receives reassigned benefits from 9 practitioners
Practice locations: Millis, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1295309953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 MAIN ST STE 207",
            "city": "MILLIS",
            "state": "MA",
            "postal_code": "020541555",
            "telephone_number": "508-918-2185",
            "fax_number": "508-974-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 MAIN ST STE 207",
            "city": "MILLIS",
            "state": "MA",
            "postal_code": "020541555",
            "telephone_number": "508-918-2185",
            "fax_number": "508-974-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE CHIROPRACTIC AND PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-918-2185",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.