Organization Active NPI

Chestnut Hills Chiropractic Center

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1447458252
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHESTNUT HILLS CHIROPRACTIC CENTER
Practice address
971 Chestnut Hills Pkwy
Fort Wayne, IN 46814-8932
Phone
(260) 625-6511
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Dr. Daniel Vern Velliquette, D.C.NPI 1962586685
Title
Owner
Phone
(260) 625-6511

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 Primary

Addresses

Primary practice location

971 Chestnut Hills Pkwy
Fort Wayne, IN 46814-8932

Mailing address

971 Chestnut Hills Pkwy
Fort Wayne, IN 46814-8932
Phone (260) 625-6511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414000396 IN Part B Supplier - Clinic/Group Practice 3779577408 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

971 Chestnut Hills Pkwy
Fort Wayne, IN 46814
Phone (260) 435-1700

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": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1447458252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 CHESTNUT HILLS PKWY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468148932",
            "telephone_number": "260-625-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 CHESTNUT HILLS PKWY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468148932",
            "telephone_number": "260-625-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT HILLS CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "VELLIQUETTE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "VERN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-625-6511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 Feb 26, 2008; 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.