Individual provider Active NPI

John Williams Stevens, D.C.

  • Chiropractor
  • Chinchilla, PA
National Provider Identifier
1528161460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AJ-005225-L Issued in PA
Practice address
330 Northern Boulevard
Suite 447
Chinchilla, PA 18410
Phone
(570) 586-0707
Fax
(570) 587-5979
NPI assigned
Sep 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X AJ-005225-L PA Primary

Addresses

Primary practice location

330 Northern Boulevard
Suite 447
Chinchilla, PA 18410

Mailing address

PO Box 447
RT. 6 & 11 Northern Blvd.
Chinchilla, PA 18410-0447
Phone (570) 586-0707

Other identifiers 2

IdentifierTypeStateIssuer
479811OtherPABLUE SHIELD
804331OtherPAFIRST PRIORITY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000699 PA Practitioner - Chiropractic 3678550829 Practice locations: South Abington Township, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

330 Northern Blvd
Chinchilla, PA 18411-9305

330 Northern Boulevard
Chinchilla, PA 18410-0447

P O Box
Suite 447
Cinchilla, PA 18410-0447

PO Box
Suite 447
Chinchilla, PA 18410-0447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AJ-005225-LPAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528161460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "address_2": "RT. 6 & 11 NORTHERN BLVD.",
            "city": "CHINCHILLA",
            "state": "PA",
            "postal_code": "184100447",
            "telephone_number": "570-586-0707",
            "fax_number": "570-587-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 NORTHERN BOULEVARD",
            "address_2": "SUITE 447",
            "city": "CHINCHILLA",
            "state": "PA",
            "postal_code": "18410",
            "telephone_number": "570-586-0707",
            "fax_number": "570-587-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JOHN",
        "middle_name": "WILLIAMS",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "AJ-005225-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "479811",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "804331",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chinchilla, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.