John NMN Pedrow, CHIROPRACTOR

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC001680L Issued in PA

Practice address

14429 Route 30
N Huntingdon, PA 15642-1057

Phone

(412) 823-8090

Fax

(412) 829-1829

NPI assigned

Jun 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609078690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14429 ROUTE 30",
            "city": "N HUNTINGDON",
            "state": "PA",
            "postal_code": "156421057",
            "telephone_number": "412-823-8090",
            "fax_number": "412-829-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14429 ROUTE 30",
            "city": "N HUNTINGDON",
            "state": "PA",
            "postal_code": "156421057",
            "telephone_number": "412-823-8090",
            "fax_number": "412-829-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDROW",
        "first_name": "JOHN",
        "middle_name": "NMN",
        "name_prefix": "Dr.",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC001680L",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH3608",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "CH3608",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "25-1400613",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DC001680L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in N Huntingdon, PA
• Providers in N Huntingdon, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.