Organization Active NPI

Rolley Family Chiropractic, P.C.

  • Chiropractor
  • Saint Marys, PA
National Provider Identifier
1598786741
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007825L Issued in PA
Legal business name
ROLLEY FAMILY CHIROPRACTIC, P.C.
Practice address
628 S Saint Marys St
Saint Marys, PA 15857-1680
Phone
(814) 834-1045
Fax
(814) 781-8309
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ronald J. Rolley Jr., D.C.NPI 1477576569
Title
President/Doctor of Chiropractic
Phone
(814) 834-1045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC007825L PA Primary

Addresses

Primary practice location

628 S Saint Marys St
Saint Marys, PA 15857-1680

Mailing address

628 S Saint Marys St
Saint Marys, PA 15857-1680
Phone (814) 834-1045

Other identifiers 1

IdentifierTypeStateIssuer
0018240290001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050602000634 PA Part B Supplier - Clinic/Group Practice 5799728572 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Marys, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598786741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 S SAINT MARYS ST",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158571680",
            "telephone_number": "814-834-1045",
            "fax_number": "814-781-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 S SAINT MARYS ST",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158571680",
            "telephone_number": "814-834-1045",
            "fax_number": "814-781-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLEY FAMILY CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROLLEY",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT/DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "814-834-1045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007825L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018240290001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.