Coliseum Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

COLISEUM CHIROPRACTIC PLLC

Practice address

138 Jim St
Morgantown, WV 26501-5302

Phone

(304) 482-8934

NPI assigned

Jun 2, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Chad Porter, DCNPI 1477082048

Title

Owner

Phone

(304) 482-8934

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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.

• Chad Michael Porter, DC

  • Chiropractor
  • Bridgeport, WV
  • NPI 1477082048
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1447826250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 JIM ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265015302",
            "telephone_number": "304-244-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 JIM ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265015302",
            "telephone_number": "304-482-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLISEUM CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-482-8934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Michael Coleman, M.D.
• Kennith Conley Coleman, DO
• Matthew Coleman, MD
• Michelle M Coleman
• Shannon Jill Coleman
• Sally Louise Colland
• Jason Collett
• Karriel Nicole Collington
• Chelsea Collins, NP
• Kelly Lynn Collins, PHARMACIST

• Chiropractor in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Chiropractor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.