NPIMap

Organization Active NPI

Fairley Chiropractic Inc.

  • Chiropractor
  • Oakland, CA
National Provider Identifier
1497337216
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FAIRLEY CHIROPRACTIC INC.
Practice address
3825 Macarthur Blvd
Oakland, CA 94619-1361
Phone
(510) 328-1381
Fax
(844) 273-4643
NPI assigned
Apr 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Dr. Jordan Fairley, DC
Title
Chiropractor
Phone
(510) 328-1381

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3825 Macarthur Blvd
Oakland, CA 94619-1361

Mailing address

3825 Macarthur Blvd
Oakland, CA 94619-1361
Phone (510) 328-1381

Other names 1

  • The Source Chiropractic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@thesourcechiropractic.com

National Provider Directory

National Provider Directory

Locations

3825 MacArthur Blvd
Oakland, CA 94619
Phone (510) 328-1381

Practitioners & affiliated clinicians

Practitioners 7

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": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1497337216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946191361",
            "telephone_number": "510-328-1381",
            "fax_number": "844-273-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946191361",
            "telephone_number": "510-328-1381",
            "fax_number": "844-273-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRLEY CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "FAIRLEY",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "510-328-1381",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@thesourcechiropractic.com",
            "affiliation": "N",
            "address_1": "3825 MacArthur Blvd",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946191361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Source Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.