Philly Spine Center Incorporated

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC010122 Issued in PA

Legal business name

PHILLY SPINE CENTER INCORPORATED

Practice address

3101 Cottman Ave
Philadelphia, PA 19149-1502

Phone

(215) 624-6100

NPI assigned

Sep 5, 2012

Last updated

Sep 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Winfield Holloway, D.C.NPI 1639354905

Title

Chiropractor

Phone

(404) 428-6012

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Winfield Holloway, BS DC

  • Chiropractor
  • Philadelphia, PA
  • NPI 1639354905
  NPD (past) Authorized official

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1366791428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MULBERRY LN",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622438",
            "telephone_number": "404-428-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491502",
            "telephone_number": "215-624-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLY SPINE CENTER INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "WINFIELD",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "404-428-6012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philly Pharmacy LLC (Philly Pharmacy)
• Philly Pregnancy Center PC
• Philly Psychology LLC
• Philly Speech and Language LLC
• Philly Speech and Language Therapy Inc.
• Philly Wellness Center LLC
• Phillycare Coaching LLC
• Phillymedclub PLLC
• Philmont Homecare, LLC
• Linda Philogene, MSW,LCSW

• Chiropractor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.