Organization Active NPI

Red Lion Chiropractic, Inc.

  • Chiropractor
  • Red Lion, PA
National Provider Identifier
1497785638
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002379L Issued in PA
Legal business name
RED LION CHIROPRACTIC, INC.
Practice address
631 Lombard Rd
Red Lion, PA 17356-9054
Phone
(717) 840-0888
Fax
(717) 840-4369
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Authorized official

Name
Dr. Joseph Allan Fuller, D.C.NPI 1992770531
Title
Corp Pres; D.C.
Phone
(717) 840-0888

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC002379L PA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC006112L PA

Addresses

Primary practice location

631 Lombard Rd
Red Lion, PA 17356-9054

Mailing address

631 Lombard Rd
Red Lion, PA 17356-9054
Phone (717) 840-0888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706000489 PA Part B Supplier - Clinic/Group Practice 3173500394 Receives reassigned benefits from 2 practitioners
Practice locations: Red Lion, PA

National Provider Directory

National Provider Directory

Locations

631 Lombard Rd
Red Lion, PA 17356
Phone (717) 840-0888

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 49

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1497785638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 LOMBARD RD",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173569054",
            "telephone_number": "717-840-0888",
            "fax_number": "717-840-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 LOMBARD RD",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173569054",
            "telephone_number": "717-840-0888",
            "fax_number": "717-840-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED LION CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "CORP PRES; D.C.",
        "authorized_official_telephone_number": "717-840-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002379L",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006112L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Lion, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.