Chiropractic & PT Center of Turf Valley, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01969 Issued in MD

Legal business name

CHIROPRACTIC & PT CENTER OF TURF VALLEY, LLC

Practice address

10729 Birmingham Way
Suite a
Woodstock, MD 21163-1403

Phone

(410) 461-0080

Fax

(410) 461-8566

NPI assigned

Oct 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William Gerard Dolengo, D.C.NPI 1093865784

Title

Owner/Chiropractor/Physical Therapy

Phone

(410) 461-0080

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William G Dolengo, D.C.

  • Chiropractor
  • Woodstock, MD
  • NPI 1093865784
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1306025028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10729 BIRMINGHAM WAY",
            "address_2": "SUITE A",
            "city": "WOODSTOCK",
            "state": "MD",
            "postal_code": "211631403",
            "telephone_number": "410-461-0080",
            "fax_number": "410-461-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10729 BIRMINGHAM WAY",
            "address_2": "SUITE A",
            "city": "WOODSTOCK",
            "state": "MD",
            "postal_code": "211631403",
            "telephone_number": "410-461-0080",
            "fax_number": "410-461-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC & PT CENTER OF TURF VALLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "DOLENGO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR/PHYSICAL THERAPY",
        "authorized_official_telephone_number": "410-461-0080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "N162-0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1077382",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HC/MAMSI",
            "identifier": "4114301",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "620634-02",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roberta Lynn Brown, PHARM.D.
• Denise Ann Butcher, LMSW-C
• Natalie Ann Carlyle, PHARMD
• Bruce Alan Cavanaugh, PA-C
• Susan S. Chicca, LCSW-C BCD
• William G Dolengo, D.C.
• Sandra English, L.AC.
• Foot Savers Inc.
• Judy Johnson Grados, PSY.D.
• Victor Grays Sr.

• Chiropractor in Woodstock, MD
• Providers in Woodstock, MD by specialty
• Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.