Fultz Family Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC010678 Issued in PA

Legal business name

FULTZ FAMILY CHIROPRACTIC LLC

Practice address

5321 Main Rd
Sweet Valley, PA 18656-2340

Phone

(570) 477-2778

Fax

(570) 477-3572

NPI assigned

Jun 2, 2014

Organization subpart

No

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

Authorized official

Name

David Christopher Fultz, D.C.NPI 1588900435

Title

Owner

Phone

(570) 477-2778

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

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

• David Christopher Fultz, DC

  • Chiropractor
  • Sweet Valley, PA
  • NPI 1588900435
  Medicare reassignment NPD Authorized official
• James Adam Kliamovich II, D.C.

  • Chiropractor
  • Sweet Valley, PA
  • NPI 1225034523
  NPD (past)

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1528470093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 MAIN RD",
            "city": "SWEET VALLEY",
            "state": "PA",
            "postal_code": "186562340",
            "telephone_number": "570-477-2778",
            "fax_number": "570-477-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5321 MAIN RD",
            "city": "SWEET VALLEY",
            "state": "PA",
            "postal_code": "186562340",
            "telephone_number": "570-477-2778",
            "fax_number": "570-477-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTZ FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "FULTZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-477-2778",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "158890",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "832683",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029091880001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH",
            "identifier": "1150787",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen M Buerger Talacka, DC
• Sharon Marie Clark, LPC
• Fairmount Township Volunteer Fire Co No 1
• David Christopher Fultz, DC
• Functional Connections, LLC
• James a Kliamovich II
• Stephanie Jean Jones
• James Adam Kliamovich II, D.C.

• Chiropractor in Sweet Valley, PA
• Providers in Sweet Valley, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.