Individual provider Active NPI

Glenn Edward Macwhorter, D.C.

  • Radiology Chiropractor
  • Capitola, CA
National Provider Identifier
1598718629
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
License
13598 Issued in CA
Practice address
716 Capitola Ave
Capitola, CA 95010-2777
Phone
(831) 479-1213
Fax
(831) 479-1016
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Chiropractor 111NR0200X 13598 CA Primary

Addresses

Primary practice location

716 Capitola Ave
Capitola, CA 95010-2777

Mailing address

1525 Calypso Dr.
Aptos, CA 95003
Phone (831) 479-1213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100316000830 CA Practitioner - Chiropractic 0749315760 Reassigns benefits to 1 organization
Practice locations: Capitola, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Cruz Community Health Centers CurrentSince Sep 27, 2009 Accepting new patients
Santa Cruz Community Health Centers CurrentSince Sep 27, 2009 Accepting new patients

Locations

250 Locust St
Santa Cruz, CA 95060
Phone (831) 427-3582

21507 E Cliff Dr
Santa Cruz, CA 95062
Phone (510) 520-7299

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1598718629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 CALYPSO DR.",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "95003",
            "telephone_number": "831-479-1213",
            "fax_number": "831-479-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 CAPITOLA AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102777",
            "telephone_number": "831-479-1213",
            "fax_number": "831-479-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACWHORTER",
        "first_name": "GLENN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "CA",
            "license": "13598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.