NPIMap

Organization Active NPI

Woburn Family Chiropractic Inc

  • Chiropractor
  • Woburn, MA
National Provider Identifier
1427160688
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
157 Issued in MA
Legal business name
WOBURN FAMILY CHIROPRACTIC INC
Practice address
20 Cummings Park
Woburn, MA 01801
Phone
(781) 938-9400
Fax
(871) 938-9323
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Todd Pendolino, DCNPI 1194739573
Title
President
Phone
(781) 938-9400

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
Chiropractor 111N00000X 157 MA Primary

Addresses

Primary practice location

20 Cummings Park
Woburn, MA 01801

Mailing address

20 Cummings Park
Woburn, MA 01801
Phone (781) 938-9400

Other identifiers 5

IdentifierTypeStateIssuer
1697021MedicaidMA
460083OtherTUFTS
Y39772OtherBLUE CROSS BLUE SHIELD
AA7544OtherHARVARD PILGRIM
2611483OtherAETNA

National Provider Directory

National Provider Directory
Tax ID family
North Shore Spine Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427160688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-938-9400",
            "fax_number": "871-938-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-938-9400",
            "fax_number": "871-938-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOBURN FAMILY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENDOLINO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-938-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1697021",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "460083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y39772",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA7544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2611483",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.