Individual provider Active NPI

Rachel Ann Vantine

  • Chiropractor
  • Hawley, PA
National Provider Identifier
1316534316
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011595 Issued in PA
Practice address
74 Welwood Ave Ste 101
Hawley, PA 18428-1577
Phone
(570) 493-1324
NPI assigned
Dec 23, 2020
Last updated
Dec 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011595 PA Primary

Addresses

Primary practice location

74 Welwood Ave Ste 101
Hawley, PA 18428-1577

Mailing address

74 Welwood Ave Ste 101
Hawley, PA 18428-1577
Phone (570) 493-1324

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210210000511 PA Practitioner - Chiropractic 3274948955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocono Functional Rehabilitation, PLLCGroup PAC ID 5294165130, 3 clinicians

Practice addresses (Care Compare)

74 Welwood Ave
Suite 101
Hawley, PA 18428-1577
Phone (570) 226-4119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pocono Functional Rehabilitation, PLLC Chiropractor CurrentSince Dec 23, 2020 Accepting new patients

Locations

74 Welwood Ave
Ste 101
Hawley, PA 18428
Phone (570) 226-4119

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1316534316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 WELWOOD AVE STE 101",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184281577",
            "telephone_number": "570-493-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 WELWOOD AVE STE 101",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184281577",
            "telephone_number": "570-493-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTINE",
        "first_name": "RACHEL",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.