Organization Active NPI

Advanced Chiropractic Pain Relief Center

  • Chiropractor
  • Saint Marys, PA
National Provider Identifier
1457384240
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC009029 Issued in PA
Legal business name
ADVANCED CHIROPRACTIC PAIN RELIEF CENTER
Practice address
835 South Saint Marys Road
Saint Marys, PA 15857
Phone
(814) 781-3355
NPI assigned
Jul 8, 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. Jamey AzzatoNPI 1043260193
Title
Owner/Doctor
Phone
(814) 781-3355

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 DC009029 PA Primary

Addresses

Primary practice location

835 South Saint Marys Road
Saint Marys, PA 15857

Mailing address

835 South Saint Marys Road
Saint Marys, PA 15857

Other identifiers 1

IdentifierTypeStateIssuer
AZ1468700OtherPABCBS PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061018000060 PA Part B Supplier - Clinic/Group Practice 5496751208 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Marys, PA

National Provider Directory

National Provider Directory

Locations

835 S Saint Marys St
Saint Marys, PA 15857
Phone (814) 781-3355

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457384240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SOUTH SAINT MARYS ROAD",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "15857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SOUTH SAINT MARYS ROAD",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "15857",
            "telephone_number": "814-781-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHIROPRACTIC PAIN RELIEF CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AZZATO",
        "authorized_official_first_name": "JAMEY",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "814-781-3355",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "AZ1468700",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, PA

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.
  • 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.