Organization Active NPI

Qualls Comprehensive Chiropractic Inc

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1528256310
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2030 Issued in AZ
Legal business name
QUALLS COMPREHENSIVE CHIROPRACTIC INC
Practice address
12020 N 35TH Ave
Ste 102
Phoenix, AZ 85029-3213
Phone
(602) 862-9419
Fax
(866) 905-5721
NPI assigned
Oct 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Richard A Qualls Jr., DC
Title
Owner
Phone
(602) 862-9419

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2030 AZ Primary

Addresses

Primary practice location

12020 N 35TH Ave
Ste 102
Phoenix, AZ 85029-3213

Mailing address

12020 N 35TH Ave
Ste 102
Phoenix, AZ 85029-3213
Phone (602) 862-9419

Other identifiers 1

IdentifierTypeStateIssuer
AZ0938530OtherAZBCBS

National Provider Directory

National Provider Directory

Locations

12020 N 35th Ave
Ste 102
Phoenix, AZ 85029
Phone (602) 862-9419

Practitioners & affiliated clinicians

Practitioners 2

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": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1528256310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 N 35TH AVE",
            "address_2": "STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293213",
            "telephone_number": "602-862-9419",
            "fax_number": "866-905-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 N 35TH AVE",
            "address_2": "STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293213",
            "telephone_number": "602-862-9419",
            "fax_number": "866-905-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALLS COMPREHENSIVE CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "QUALLS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-862-9419",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "2030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0938530",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.