Be Transformed Chiropractic, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-004904-L Issued in PA

Legal business name

BE TRANSFORMED CHIROPRACTIC, INC

Practice address

2609 Jenkintown Rd
Glenside, PA 19038-2501

Phone

(215) 659-7345

Fax

(215) 780-1221

NPI assigned

Sep 29, 2006

Last updated

Jan 3, 2022By 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

Mark E Barnard

Title

Owner

Phone

(215) 659-7345

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 2

• Barnard Chiropractic, Inc Former legal business name
• Healthsource Of Abington Former legal business name

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1376635805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 JENKINTOWN RD",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190382501",
            "telephone_number": "215-659-7345",
            "fax_number": "215-780-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 JENKINTOWN RD",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190382501",
            "telephone_number": "215-659-7345",
            "fax_number": "215-780-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BE TRANSFORMED CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "BARNARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-659-7345"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-004904-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003901",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1438519",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "2123264000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Barnard Chiropractic, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Healthsource Of Abington",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Healthsource Of Abington",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Mary Beth Berardi, D.O.T.
• Rachel Boas
• Theresa Bradish

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.