Organization Active NPI

Essex Chiropractic

  • Chiropractor
  • Lawrence, MA
National Provider Identifier
1366638371
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2154 Issued in MA
Legal business name
ESSEX CHIROPRACTIC
Practice address
493 Essex St
Lawrence, MA 01840-1241
Phone
(978) 686-7111
Fax
(978) 686-5502
NPI assigned
Sep 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Authorized official

Name
Dr. Michael L Provenzano, DC,DPTNPI 1225157423
Title
Partner
Phone
(978) 686-7111

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 2154 MA Primary

Addresses

Primary practice location

493 Essex St
Lawrence, MA 01840-1241

Mailing address

493 Essex St
Lawrence, MA 01840-1241
Phone (978) 686-7111

Other identifiers 1

IdentifierTypeStateIssuer
Y39894OtherMABCBS

National Provider Directory

National Provider Directory

Locations

93 Washington St
Haverhill, MA 01832
Phone (978) 374-0700

Practitioners & affiliated clinicians

Practitioners 2

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": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1366638371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 ESSEX ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401241",
            "telephone_number": "978-686-7111",
            "fax_number": "978-686-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 ESSEX ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401241",
            "telephone_number": "978-686-7111",
            "fax_number": "978-686-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSEX CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "PROVENZANO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "978-686-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC,DPT"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y39894",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.