NPIMap

Organization Active NPI

Life Chiropractic and Injury Center LLC

  • Multi-Specialty Clinic/Center
  • Riverdale, MD
National Provider Identifier
1508402074
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LIFE CHIROPRACTIC AND INJURY CENTER LLC
Practice address
6103 Baltimore Ave Ste 101
Riverdale, MD 20737-1966
Phone
(240) 467-5600
Fax
(240) 467-5626
NPI assigned
Nov 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Authorized official

Name
Dr. Benjamin Haner, DCNPI 1598823189
Title
Sole Member
Phone
(240) 467-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

6103 Baltimore Ave Ste 101
Riverdale, MD 20737-1966

Mailing address

6103 Baltimore Ave Ste 101
Riverdale, MD 20737-1966
Phone (240) 467-5600

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL drben@lifechiropracticandinjurycenter.com Direct

National Provider Directory

National Provider Directory

Locations

6103 Baltimore Ave
Ste 101
Riverdale, MD 20737
Phone (240) 467-5600

Practitioners & affiliated clinicians

Practitioners 1

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": "1574208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574208000000",
    "number": "1508402074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6103 BALTIMORE AVE STE 101",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371966",
            "telephone_number": "240-467-5600",
            "fax_number": "240-467-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6103 BALTIMORE AVE STE 101",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371966",
            "telephone_number": "240-467-5600",
            "fax_number": "240-467-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHIROPRACTIC AND INJURY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A",
        "authorized_official_last_name": "HANER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "240-467-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drben@lifechiropracticandinjurycenter.com",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail",
            "address_1": "6103 Baltimore Ave Ste 101",
            "city": "Riverdale",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207371966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverdale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.