NPIMap

Organization Active NPI

Phillips-White Chiropractic Corporation

  • Chiropractor
  • Redlands, CA
National Provider Identifier
1336265362
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
22122 Issued in CA
Legal business name
PHILLIPS-WHITE CHIROPRACTIC CORPORATION
Practice address
620 Alabama St
Redlands, CA 92373-8059
Phone
(909) 792-4434
NPI assigned
Mar 21, 2007
Last updated
Oct 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Jeffrey Phillips, D.C.NPI 1174674089
Title
President
Phone
(909) 792-4434

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 22122 CA Primary

Addresses

Primary practice location

620 Alabama St
Redlands, CA 92373-8059

Mailing address

PO Box 1129
Redlands, CA 92373-0363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101023000153 CA Part B Supplier - Clinic/Group Practice 7719170687 Receives reassigned benefits from 12 practitioners
Practice locations: Redlands, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1336265362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1129",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ALABAMA ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738059",
            "telephone_number": "909-792-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS-WHITE CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-792-4434",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "22122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.