NPIMap

Organization Active NPI

Synergy Chiropractic of Johnstown PC

  • Chiropractor
  • Johnstown, PA
National Provider Identifier
1316474794
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011230 Issued in PA
Legal business name
SYNERGY CHIROPRACTIC OF JOHNSTOWN PC
Practice address
969 Eisenhower Blvd Ste L
Johnstown, PA 15904-3326
Phone
(814) 262-0400
NPI assigned
May 17, 2017
Last updated
Jun 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Authorized official

Name
Matthew Duray, DCNPI 1518330307
Title
President
Phone
(814) 262-0400

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC011230 PA Primary

Addresses

Primary practice location

969 Eisenhower Blvd Ste L
Johnstown, PA 15904-3326

Mailing address

969 Eisenhower Blvd Ste L
Johnstown, PA 15904-3326
Phone (814) 262-0400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170621001097 PA Part B Supplier - Clinic/Group Practice 6103194840 Receives reassigned benefits from 3 practitioners
Practice locations: Johnstown, PA

National Provider Directory

National Provider Directory

Locations

334 Budfield St
Ste 100
Johnstown, PA 15904
Phone (814) 262-0400

969 Eisenhower Blvd
Ste L
Johnstown, PA 15904
Phone (814) 262-0400

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": "1494979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497916800000",
    "number": "1316474794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 EISENHOWER BLVD STE L",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043326",
            "telephone_number": "18142620400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 EISENHOWER BLVD STE L",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043326",
            "telephone_number": "814-262-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY CHIROPRACTIC OF JOHNSTOWN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-17",
        "last_updated": "2017-06-20",
        "status": "A",
        "authorized_official_last_name": "DURAY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-262-0400",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; 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.