Athletic Edge Chiropractic & Rehabilitation LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC009828 Issued in PA

Legal business name

ATHLETIC EDGE CHIROPRACTIC & REHABILITATION LLC

Practice address

1982 Butler Pike
Suite #2
Conshohocken, PA 19428-3701

Phone

(610) 940-6756

Fax

(610) 940-6797

NPI assigned

Sep 12, 2007

Last updated

Jan 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Heather Nicole Goldberg, DCNPI 1740208347

Title

Owner

Phone

(610) 940-6756

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather Nicole Goldberg, DC

  • Chiropractor
  • Conshohocken, PA
  • NPI 1740208347
  Authorized official Same address or phone

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388707200000",
    "number": "1609061654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1982 BUTLER PIKE",
            "address_2": "SUITE #2",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194283701",
            "telephone_number": "610-940-6756",
            "fax_number": "610-940-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1982 BUTLER PIKE",
            "address_2": "SUITE #2",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194283701",
            "telephone_number": "610-940-6756",
            "fax_number": "610-940-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC EDGE CHIROPRACTIC & REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2014-01-03",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-940-6756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Conshohocken, PA
• Providers in Conshohocken, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.