Individual provider Active NPI

Ahmad Adil Ansari, D.C.

  • Chiropractor
  • Philadelphia, PA
National Provider Identifier
1366777815
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC009719 Issued in PA
Practice address
4607 N Broad St
Philadelphia, PA 19140-1217
Phone
(215) 329-6136
NPI assigned
Oct 15, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC009719 PA Primary

Addresses

Primary practice location

4607 N Broad St
Philadelphia, PA 19140-1217

Mailing address

13109 Bustleton Ave
Apt C-20
Philadelphia, PA 19116-1647
Phone (248) 703-3342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC009719PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Wellness Group PLLC Chiropractor Past Accepting new patients

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1366777815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13109 BUSTLETON AVE",
            "address_2": "APT C-20",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191161647",
            "telephone_number": "248-703-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191401217",
            "telephone_number": "215-329-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSARI",
        "first_name": "AHMAD",
        "middle_name": "ADIL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-15",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.