Organization Active NPI

Corefit Chiropractic

  • Chiropractor
  • Allentown, PA
National Provider Identifier
1487017307
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006644L Issued in PA
Legal business name
COREFIT CHIROPRACTIC
Practice address
1124 Glenlivet Dr
Allentown, PA 18106-3104
Phone
(610) 554-8290
NPI assigned
Mar 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Authorized official

Name
Mr. Mark E Walter, D.CNPI 1619939543
Title
Owner/President
Phone
(610) 554-8290

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 DC006644L PA Primary

Addresses

Primary practice location

1124 Glenlivet Dr
Allentown, PA 18106-3104

Mailing address

3877 Highpoint Dr
Allentown, PA 18103-6142
Phone (610) 554-8290

Other identifiers 1

IdentifierTypeStateIssuer
0017938440003MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160715000725 PA Part B Supplier - Clinic/Group Practice 5496047193 Receives reassigned benefits from 1 practitioner
Practice locations: Allentown, PA

National Provider Directory

National Provider Directory

Locations

1150 Glenlivet Dr
Ste A15
Allentown, PA 18106
Phone (484) 201-2130

1150 Glenlivet Dr
Ste A1
Allentown, PA 18106

1150 Glenlivet Dr
Allentown, PA 18106
Phone (484) 793-2689

Practitioners & affiliated clinicians

Practitioners 6

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": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1487017307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3877 HIGHPOINT DR",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036142",
            "telephone_number": "610-554-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 GLENLIVET DR",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181063104",
            "telephone_number": "610-554-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COREFIT CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "610-554-8290",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006644L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017938440003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.