Organization Active NPI

Back in Line Chiropractic and Wellness Center, PC

  • Rehabilitation Hospital Unit
  • Easton, PA
National Provider Identifier
1316211865
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
DC009700 Issued in PA
Legal business name
BACK IN LINE CHIROPRACTIC AND WELLNESS CENTER, PC
Practice address
300 Cattell St FL 1
Easton, PA 18042-7606
Phone
(610) 258-0252
NPI assigned
Mar 1, 2012
Last updated
Oct 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Authorized official

Name
Mrs. Nicole Barbara Jensen, D.C.
Title
President
Phone
(267) 374-8788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X DC009700 PA Primary

Addresses

Primary practice location

300 Cattell St FL 1
Easton, PA 18042-7606

Mailing address

300 Cattell St FL 1
Easton, PA 18042-7606
Phone (610) 258-0252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120531000588 PA Part B Supplier - Clinic/Group Practice 2466615422 Receives reassigned benefits from 1 practitioner
Practice locations: Easton, PA

National Provider Directory

National Provider Directory
Tax ID family
Back in Line Chiropractic and Wellness 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

300 Cattell St
Easton, PA 18042
Phone (610) 256-0252

300 Cattell St
Fl 1
Easton, PA 18042
Phone (610) 258-0252

Practitioners & affiliated clinicians

Practitioners 2

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": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1316211865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CATTELL ST FL 1",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180427606",
            "telephone_number": "610-258-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CATTELL ST FL 1",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180427606",
            "telephone_number": "610-258-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN LINE CHIROPRACTIC AND WELLNESS CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "BARBARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-374-8788",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "PA",
            "license": "DC009700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.