Organization Active NPI

Payne Chiropractic, Inc.

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1336288109
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
21466 Issued in CA
Legal business name
PAYNE CHIROPRACTIC, INC.
Doing business as
River Oaks Chiropractic
Practice address
670 River Oaks Pkwy Ste K
San Jose, CA 95134-1988
Phone
(408) 435-1133
Fax
(408) 435-1166
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Larry C Payne, D.C.NPI 1316011067
Title
President
Phone
(408) 435-1133

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 21466 CA Primary

Addresses

Primary practice location

670 River Oaks Pkwy Ste K
San Jose, CA 95134-1988

Mailing address

670 River Oaks Pkwy Ste K
San Jose, CA 95134-1988
Phone (408) 435-1133

Other names 1

  • River Oaks Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050808000910 CA Part B Supplier - Clinic/Group Practice 2860421039 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

670 River Oaks Pkwy
Ste K
San Jose, CA 95134
Phone (408) 435-1133

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336288109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 RIVER OAKS PKWY STE K",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341988",
            "telephone_number": "408-435-1133",
            "fax_number": "408-435-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 RIVER OAKS PKWY STE K",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341988",
            "telephone_number": "408-435-1133",
            "fax_number": "408-435-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYNE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-435-1133",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Oaks Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.