Central PA Spinal Health Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

009494 Issued in PA

Legal business name

CENTRAL PA SPINAL HEALTH CHIROPRACTIC, LLC

Practice address

21 N 4TH St
Harrisburg, PA 17101-1822

Phone

(717) 233-3476

NPI assigned

Nov 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jason FullmerNPI 1417985227

Title

Owner

Phone

(717) 233-3476

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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

• Jason Michael Fullmer, DC

  • Chiropractor
  • Harrisburg, PA
  • NPI 1417985227
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1356522619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 N 4TH ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171011822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 N 4TH ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171011822",
            "telephone_number": "717-233-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PA SPINAL HEALTH CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "FULLMER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-233-3476",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "009494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.