NPIMap

Organization Active NPI

Keystone Pain Management

  • Chiropractor
  • Upper Darby, PA
National Provider Identifier
1356660997
Registry record updated May 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007527L Issued in PA
Legal business name
KEYSTONE PAIN MANAGEMENT
Practice address
7016 Terminal SQ
Suite 10a
Upper Darby, PA 19082-2337
Phone
(610) 352-1710
Fax
(610) 352-1740
NPI assigned
May 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2010

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

Authorized official

Name
Jarrad Teller, DC
Title
Owner
Phone
(610) 351-1710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC007527L PA Primary

Addresses

Primary practice location

7016 Terminal SQ
Suite 10a
Upper Darby, PA 19082-2337

Mailing address

PO Box 154
Cedar Brook, NJ 08018-0154
Phone (609) 704-1857

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274400000000",
    "number": "1356660997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 154",
            "city": "CEDAR BROOK",
            "state": "NJ",
            "postal_code": "080180154",
            "telephone_number": "609-704-1857",
            "fax_number": "609-704-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7016 TERMINAL SQ",
            "address_2": "SUITE 10A",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822337",
            "telephone_number": "610-352-1710",
            "fax_number": "610-352-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-21",
        "last_updated": "2010-05-21",
        "status": "A",
        "authorized_official_last_name": "TELLER",
        "authorized_official_first_name": "JARRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-351-1710",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007527L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Darby, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.