Organization Active NPI

Hildebrand Chiropractic, Inc.

  • Chiropractor
  • State College, PA
National Provider Identifier
1346592250
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HILDEBRAND CHIROPRACTIC, INC.
Practice address
1460 Martin St
State College, PA 16803-3065
Phone
(814) 238-8540
Fax
(814) 238-8638
NPI assigned
Oct 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Authorized official

Name
Dr. Russell Joseph Hildebrand, D.C.NPI 1427234038
Title
Chiropractor
Phone
(814) 238-8540

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 Primary

Addresses

Primary practice location

1460 Martin St
State College, PA 16803-3065

Mailing address

1460 Martin St
State College, PA 16803-3065
Phone (814) 238-8540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121025000736 PA Part B Supplier - Clinic/Group Practice 5395995476 Receives reassigned benefits from 1 practitioner
Practice locations: State College, PA

National Provider Directory

National Provider Directory

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": "1349222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1346592250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 MARTIN ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168033065",
            "telephone_number": "814-238-8540",
            "fax_number": "814-238-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MARTIN ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168033065",
            "telephone_number": "814-238-8540",
            "fax_number": "814-238-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILDEBRAND CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "HILDEBRAND",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "814-238-8540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.