Simi Spine and Wellness a Chiropractic Corporation of Shawn Decloedt

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SIMI SPINE AND WELLNESS A CHIROPRACTIC CORPORATION OF SHAWN DECLOEDT

Practice address

3655 Alamo St Ste 201
Simi Valley, CA 93063-2187

Phone

(805) 581-2310

Fax

(805) 335-2439

NPI assigned

Apr 22, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Shawn Stuart Decloedt, DCNPI 1144461294

Title

President

Phone

(805) 581-2310

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Shawn Stuart Decloedt, D.C.

  • Chiropractor
  • Simi Valley, CA
  • NPI 1144461294
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1366005704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930621209",
            "telephone_number": "805-581-2310",
            "fax_number": "805-335-2439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 ALAMO ST STE 201",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632187",
            "telephone_number": "805-581-2310",
            "fax_number": "805-335-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMI SPINE AND WELLNESS A CHIROPRACTIC CORPORATION OF SHAWN DECLOEDT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "DECLOEDT",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-581-2310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simi Psychological Group, Apc
• Simi Radiology and Imaging Medical Group
• Simi Regional Urgent Care PC
• Simi Royal Dental Center
• Simi San Fernando Valley Urology Associates
• Simi Surgery Center Inc.
• Simi Valley Anesthesia Medical Group
• Simi Valley Birth Center
• Simi Valley Birth Center
• Simi Valley Care Home, Inc.

• Chiropractor in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.