Organization Active NPI

Smith Chiropractic Center at Arrowhead

  • Chiropractor
  • Glendale, AZ
National Provider Identifier
1396054151
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5840 Issued in AZ
Legal business name
SMITH CHIROPRACTIC CENTER AT ARROWHEAD
Practice address
18275 N 59TH Ave Ste F134
Glendale, AZ 85308-1281
Phone
(602) 789-8600
Fax
(602) 789-8601
NPI assigned
Sep 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Authorized official

Name
Dr. Jennifer M Smith, DCNPI 1720013402
Title
Owner
Phone
(602) 789-8600

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 5840 AZ Primary

Addresses

Primary practice location

18275 N 59TH Ave Ste F134
Glendale, AZ 85308-1281

Mailing address

PO Box 11543
Glendale, AZ 85318-1543
Phone (602) 789-8600

Other identifiers 2

IdentifierTypeStateIssuer
44787MedicaidAZ
AZ0937510OtherAZBLUE CROSS BLUE SHIELD

Other names 2

  • Jennifer M Smith DC PC Doing business as
  • SMITH CHIROPRACTIC CENTER AT ARROWHEAD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041028001074 AZ Part B Supplier - Clinic/Group Practice 4284696543 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, AZ

National Provider Directory

National Provider Directory

Locations

18275 N 59th Ave
Ste 134F
Glendale, AZ 85308
Phone (602) 789-8600

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": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1396054151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11543",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853181543",
            "telephone_number": "602-789-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE STE F134",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081281",
            "telephone_number": "602-789-8600",
            "fax_number": "602-789-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH CHIROPRACTIC CENTER AT ARROWHEAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-789-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44787",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0937510",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jennifer M Smith DC PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SMITH CHIROPRACTIC CENTER AT ARROWHEAD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.