Organization Active NPI

Oakley Chiropractic Kristin Mattingly D.C Corp

  • Chiropractor
  • Oakley, CA
National Provider Identifier
1487118287
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
OAKLEY CHIROPRACTIC KRISTIN MATTINGLY D.C CORP
Practice address
3478 Main St
Oakley, CA 94561-3137
Phone
(925) 625-1881
NPI assigned
Jan 25, 2019
Last updated
May 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Authorized official

Name
Dr. Kristin Mattingly, DCNPI 1518143833
Title
Owner
Phone
(925) 625-1881

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 NU Primary

Addresses

Primary practice location

3478 Main St
Oakley, CA 94561-3137

Mailing address

3478 Main St
Oakley, CA 94561-3137
Phone (925) 625-1881

Other identifiers 2

IdentifierTypeStateIssuer
1518143833OtherCAPRIVATE INSURANCE
1518143833MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190212003137 CA Part B Supplier - Clinic/Group Practice 5395083620 Receives reassigned benefits from 2 practitioners
Practice locations: Oakley, CA

National Provider Directory

National Provider Directory

Locations

3478 Main St
Oakley, CA 94561
Phone (925) 625-1881

Practitioners & affiliated clinicians

Practitioners 4

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": "1548374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557187200000",
    "number": "1487118287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3478 MAIN ST",
            "city": "OAKLEY",
            "state": "CA",
            "postal_code": "945613137",
            "telephone_number": "925-625-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3478 MAIN ST",
            "city": "OAKLEY",
            "state": "CA",
            "postal_code": "945613137",
            "telephone_number": "925-625-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLEY CHIROPRACTIC KRISTIN MATTINGLY D.C CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-05-07",
        "status": "A",
        "authorized_official_last_name": "MATTINGLY",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-625-1881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "1518143833",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518143833",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.