Total Body Chiropractic PC
Organization Active NPI Chiropractor · Taylor, PA
NPI 1487767943 · NPPES record last updated Sep 3, 2008
Key facts
- NPI
- 1487767943
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC007472L (PA)
- Legal business name
- TOTAL BODY CHIROPRACTIC PC
- Practice address
- 125 N. Main St
Taylor, PA 18517 - Phone
- (570) 562-7770
- Fax
- (570) 562-7775
- NPI assigned
- Aug 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. William Joseph Krah III, DC
- Title
- President
- Phone
- (510) 562-7770
Practitioners 9
-
Michael Maroni, DC
-
Chelsea Lynn Johnson, L.P.T.
-
James Thomas Carton, D.C.
-
Valerie A Olszewski, MSPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040308000273 | PA | Part B Supplier - Clinic/Group Practice | 2163310681 |
Receives reassigned benefits from 3 practitioners Practice locations: Taylor, PA |
National Provider Directory
Locations
1536 Main St
Peckville, PA 18452
Phone (570) 291-4450
400 N Main Ave
Scranton, PA 18504
Phone (570) 207-4238
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | DC007472L | PA | Yes |
Addresses
Primary practice location
125 N. Main St
Taylor, PA 18517
Mailing address
125 N. Main St
Taylor, PA 18517
Phone (570) 562-7770
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T0471900 | Other | BLUE SHIELD | |
| 0017749000004 | Medicaid | PA |
NPI Registry JSON
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1220400000000",
"number": "1487767943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 N. MAIN ST",
"city": "TAYLOR",
"state": "PA",
"postal_code": "18517",
"telephone_number": "570-562-7770",
"fax_number": "570-562-7775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 N. MAIN ST",
"city": "TAYLOR",
"state": "PA",
"postal_code": "18517",
"telephone_number": "570-562-7770",
"fax_number": "570-562-7775"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOTAL BODY CHIROPRACTIC PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-17",
"last_updated": "2008-09-03",
"status": "A",
"authorized_official_last_name": "KRAH",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "JOSEPH",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "510-562-7770",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "III",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "PA",
"license": "DC007472L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "T0471900",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0017749000004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Taylor, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.