Organization Active NPI

Derry Chiropractic PC

  • Chiropractor
  • Parker, CO
National Provider Identifier
1467656678
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5253 Issued in CO
Legal business name
DERRY CHIROPRACTIC PC
Practice address
12919 Stroh Ranch Court
Unit B
Parker, CO 80134
Phone
(720) 851-2475
Fax
(720) 851-2476
NPI assigned
Jun 12, 2007
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. Amy Susan Trevey, DCNPI 1245442144
Title
Owner
Phone
(720) 851-2475

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 5253 CO Primary

Addresses

Primary practice location

12919 Stroh Ranch Court
Unit B
Parker, CO 80134

Mailing address

12919 Stroh Ranch Court
Unit B
Parker, CO 80134
Phone (720) 851-2475

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070614000561 CO Part B Supplier - Clinic/Group Practice 5395843361 Receives reassigned benefits from 1 practitioner
Practice locations: Parker, CO

National Provider Directory

National Provider Directory

Locations

12900 Stroh Ranch Pl
Unit 105
Parker, CO 80134
Phone (303) 814-8000

19539 Hess Rd
Unit 108
Parker, CO 80134
Phone (303) 981-4212

Practitioners & affiliated clinicians

Practitioners 2

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": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467656678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12919 STROH RANCH COURT",
            "address_2": "UNIT B",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80134",
            "telephone_number": "720-851-2475",
            "fax_number": "720-851-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12919 STROH RANCH COURT",
            "address_2": "UNIT B",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80134",
            "telephone_number": "720-851-2475",
            "fax_number": "720-851-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERRY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TREVEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-851-2475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

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.