NPIMap

Organization Active NPI

Edgewood Chiropractic Center PC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1427260793
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8001619 Issued in IN
Legal business name
EDGEWOOD CHIROPRACTIC CENTER PC
Practice address
1114 W Cook Rd
Fort Wayne, IN 46825-3214
Phone
(260) 483-5588
Fax
(260) 489-1819
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
Dr. Christina M Bolinger, DCNPI 1689683708
Title
Co-Owner
Phone
(260) 483-5588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 8001619 IN Primary

Addresses

Primary practice location

1114 W Cook Rd
Fort Wayne, IN 46825-3214

Mailing address

1114 W Cook Rd
Fort Wayne, IN 46825-3214
Phone (260) 483-5588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090108000066 IN Part B Supplier - Clinic/Group Practice 4284797994 Receives reassigned benefits from 7 practitioners
Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

1114 W Cook Rd
Fort Wayne, IN 46825
Phone (260) 482-5588

Practitioners & affiliated clinicians

Practitioners 12

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1427260793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 W COOK RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468253214",
            "telephone_number": "260-483-5588",
            "fax_number": "260-489-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W COOK RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468253214",
            "telephone_number": "260-483-5588",
            "fax_number": "260-489-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "BOLINGER",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "260-483-5588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "8001619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.