Active Family Chiropractic, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

DC010513 Issued in PA

Legal business name

ACTIVE FAMILY CHIROPRACTIC, LLC

Practice address

4 Mylin Ave
Willow Street, PA 17584-9305

Phone

(717) 947-7283

Fax

(717) 947-7284

NPI assigned

Apr 6, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Barry Daniel Hazen, D.C.NPI 1225335755

Title

Sole Member/Owner

Phone

(717) 947-7283

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Barry D Hazen, D.C.

  • Chiropractor
  • Willow Street, PA
  • NPI 1225335755

  PA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1417311531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MYLIN AVE",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849305",
            "telephone_number": "717-947-7283",
            "fax_number": "717-947-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MYLIN AVE",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849305",
            "telephone_number": "717-947-7283",
            "fax_number": "717-947-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "HAZEN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "SOLE MEMBER/OWNER",
        "authorized_official_telephone_number": "717-947-7283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "PA",
            "license": "DC010513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A&E Audiology and Hearing Aid Center
• Robert K Aichele Jr., DO
• Oluwaseun Akangbe, M.D
• Alvin Hocke Optical Co., Inc.
• Harry J Anderson-Schick, R.PH.
• Mihaela Andrian, M.D.

• All providers in Willow Street, PA
• Medical Specialty Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.