Andrew C. Indriso, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

DC 002452L Issued in PA

Practice address

1421 Spruce St
Philadelphia, PA 19102-4533

Phone

(215) 735-2997

Fax

(215) 735-5222

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spruce Chiropractic Health Center, P.C.

  • Chiropractor
  • Philadelphia, PA
  • NPI 1134319189
  NPD (past) Authorized official

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437376704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024533",
            "telephone_number": "215-735-2997",
            "fax_number": "215-735-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024533",
            "telephone_number": "215-735-2997",
            "fax_number": "215-735-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDRISO",
        "first_name": "ANDREW",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC 002452L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC PROVIDER #",
            "identifier": "2237522000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Independent Quality Services Inc
• Independent RX Incorporated
• Independent RX Incorporated
• Jonathan Howard Indik, MD
• Indlovu, LLC
• Indulge Nursing Care Agency
• Vikranth Reddy Induru, MD
• Industrial Health Services
• Industricare Physical Rehabilitation PC
• Megan Ines, DO

• Rehabilitation Chiropractor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Rehabilitation Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.