Organization Active NPI

Early Chiropractic Corporation

  • Chiropractor
  • Modesto, CA
National Provider Identifier
1487866562
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13771 Issued in CA
Legal business name
EARLY CHIROPRACTIC CORPORATION
Practice address
3507 Tully Rd
Ste. 300
Modesto, CA 95356-1052
Phone
(209) 526-9400
Fax
(209) 526-9444
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Dr. Dean G. Early, DCNPI 1184614521
Title
Chiropractor
Phone
(209) 526-9400

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 13771 CA Primary

Addresses

Primary practice location

3507 Tully Rd
Ste. 300
Modesto, CA 95356-1052

Mailing address

3507 Tully Rd
Ste. 300
Modesto, CA 95356-1052
Phone (209) 526-9400

Other identifiers 1

IdentifierTypeStateIssuer
GDC000220MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050407000457 CA Part B Supplier - Clinic/Group Practice 2961459334 Receives reassigned benefits from 1 practitioner
Practice locations: Modesto, CA

National Provider Directory

National Provider Directory

Locations

1500 Standiford Ave
Ste B
Modesto, CA 95350
Phone (209) 577-3300

3507 Tully Rd
Ste 300
Modesto, CA 95356
Phone (209) 526-9400

4260 Sisk Rd
#E1
Modesto, CA 95356
Phone (209) 579-1115

Practitioners & affiliated clinicians

Practitioners 3

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1487866562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 TULLY RD",
            "address_2": "STE. 300",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953561052",
            "telephone_number": "209-526-9400",
            "fax_number": "209-526-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 TULLY RD",
            "address_2": "STE. 300",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953561052",
            "telephone_number": "209-526-9400",
            "fax_number": "209-526-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "EARLY",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "209-526-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "13771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GDC000220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.