NPIMap

Organization Active NPI

Holistic Center at Bristol Square PLLC

  • Chiropractor
  • Walpole, MA
National Provider Identifier
1508986787
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
262 Issued in MA
Legal business name
HOLISTIC CENTER AT BRISTOL SQUARE PLLC
Practice address
1426 Main St
Suite 6
Walpole, MA 02081-1700
Phone
(508) 660-2722
Fax
(508) 660-2621
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Authorized official

Name
Miss Nancy M. Bethoney
Title
Billing Coordinator
Phone
(508) 660-2722

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 262 MA Primary

Addresses

Primary practice location

1426 Main St
Suite 6
Walpole, MA 02081-1700

Mailing address

1426 Main St
Suite 6
Walpole, MA 02081-1700
Phone (508) 660-2722

Other names 1

  • Bristol Square Chiropractic Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160725001236 MA Part B Supplier - Clinic/Group Practice 5799078085 Receives reassigned benefits from 3 practitioners
Practice locations: Walpole, MA

National Provider Directory

National Provider Directory

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": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1508986787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 MAIN ST",
            "address_2": "SUITE 6",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020811700",
            "telephone_number": "508-660-2722",
            "fax_number": "508-660-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 MAIN ST",
            "address_2": "SUITE 6",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020811700",
            "telephone_number": "508-660-2722",
            "fax_number": "508-660-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC CENTER AT BRISTOL SQUARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "BETHONEY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "508-660-2722",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bristol Square Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Walpole, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.