NPIMap

Organization Active NPI

Nittany Valley Chiropractic Center, LLC

  • Orthopedic Chiropractor
  • State College, PA
National Provider Identifier
1295810687
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
DC03147 Issued in PA
Legal business name
NITTANY VALLEY CHIROPRACTIC CENTER, LLC
Practice address
611 University Dr
214
State College, PA 16801-6552
Phone
(814) 234-5271
Fax
(814) 234-9730
NPI assigned
Oct 26, 2006
Last updated
Jan 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Mrs. Cynthia Cornish Love
Title
Office Manager
Phone
(814) 234-5271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X DC03147 PA Primary

Addresses

Primary practice location

611 University Dr
214
State College, PA 16801-6552

Mailing address

611 University Dr
214
State College, PA 16801-6552
Phone (814) 234-5271

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150216001641 PA Part B Supplier - Clinic/Group Practice 2062737083 Receives reassigned benefits from 7 practitioners
Practice locations: Spring Mills, PA; State College, PA

National Provider Directory

National Provider Directory
Tax ID family
Nittany Valley Chiropractic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3592 Penns Valley Rd
Spring Mills, PA 16875
Phone (814) 234-5271

611 University Dr
Ste 214
State College, PA 16801
Phone (814) 234-5271

Practitioners & affiliated clinicians

Practitioners 8

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": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1295810687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 UNIVERSITY DR",
            "address_2": "214",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016552",
            "telephone_number": "814-234-5271",
            "fax_number": "814-234-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 UNIVERSITY DR",
            "address_2": "214",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016552",
            "telephone_number": "814-234-5271",
            "fax_number": "814-234-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NITTANY VALLEY CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "CORNISH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "814-234-5271",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "PA",
            "license": "DC03147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.