Individual provider Active NPI

Justin Colling Ross, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1366658387
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7827 Issued in AZ
Practice address
14640 N Tatum Blvd
Suite 7
Phoenix, AZ 85032-4824
Phone
(602) 867-7463
Fax
(602) 867-7800
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7827 AZ Primary

Addresses

Primary practice location

14640 N Tatum Blvd
Suite 7
Phoenix, AZ 85032-4824

Mailing address

3120 W Carefree Hwy
Ste 1-342
Phoenix, AZ 85086-3268
Phone (602) 826-8031

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070724000068 AZ Practitioner - Chiropractic 2466553243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Justin Ross PLCGroup PAC ID 1658466214, 2 clinicians

Practice addresses (Care Compare)

34406 N 27TH Dr
Suite 102
Phoenix, AZ 85085-7730
Phone (623) 223-1350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Justin Ross PLC Chiropractor CurrentSince Sep 27, 2007 Accepting new patients

Locations

3120 W Carefree Hwy
Ste 1342
Phoenix, AZ 85086

14640 N Tatum Blvd
Ste 7
Phoenix, AZ 85032
Phone (602) 867-1444

34406 N 27th Dr
Ste 102
Phoenix, AZ 85085
Phone (602) 344-9567

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1366658387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 W CAREFREE HWY",
            "address_2": "STE 1-342",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850863268",
            "telephone_number": "602-826-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14640 N TATUM BLVD",
            "address_2": "SUITE 7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324824",
            "telephone_number": "602-867-7463",
            "fax_number": "602-867-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JUSTIN",
        "middle_name": "COLLING",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.