Individual provider Active NPI

Jarrad Ryan Teller, D.C.

  • Chiropractor
  • Upper Darby, PA
National Provider Identifier
1578505418
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007527L Issued in PA
Practice address
7016 Terminal SQ
Suite 10a
Upper Darby, PA 19082-2310
Phone
(610) 352-1710
Fax
(610) 352-1740
NPI assigned
Jun 12, 2006
Last updated
Jan 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC007527L PA Primary

Addresses

Primary practice location

7016 Terminal SQ
Suite 10a
Upper Darby, PA 19082-2310

Mailing address

7016 Terminal SQ
Suite 10a
Upper Darby, PA 19082-2310
Phone (610) 352-1710

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120607000284 PA Practitioner - Chiropractic 4880858604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC007527LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Aopm, LLC Chiropractor CurrentSince Apr 1, 2012 Accepting new patients

Locations

9622 Bustleton Ave
Philadelphia, PA 19115
Phone (215) 620-7183

7000 Terminal Sq
Ste 100B
Upper Darby, PA 19082
Phone (215) 375-7107

7016 Terminal Sq
Ste 10A
Upper Darby, PA 19082
Phone (610) 352-1710

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1578505418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7016 TERMINAL SQ",
            "address_2": "SUITE 10A",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822310",
            "telephone_number": "610-352-1710",
            "fax_number": "610-352-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7016 TERMINAL SQ",
            "address_2": "SUITE 10A",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822310",
            "telephone_number": "610-352-1710",
            "fax_number": "610-352-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLER",
        "first_name": "JARRAD",
        "middle_name": "RYAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007527L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Darby, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.