Anderson Chiropractic, PC

Organization Active NPI Chiropractor · Albuquerque, NM

NPI 1609533249 · NPPES record last updated Jul 29, 2024

Key facts

NPI
1609533249
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
Legal business name
ANDERSON CHIROPRACTIC, PC
Practice address
4127 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Phone
(505) 308-8885
Fax
(505) 308-8886
NPI assigned
Nov 18, 2021
Organization subpart
No

Authorized official

Name
Taylor Alexis Blackford Anderson, DC
Title
Owner/Chiropractor
Phone
(505) 308-8885

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240826000159 NM Part B Supplier - Clinic/Group Practice 1759820574 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albuquerque, NM; Edgewood, NM

National Provider Directory

Tax ID family
Anderson Chiropractic PC (2 organizations share this tax ID)

Locations

1942 Old US 66
Ste B
Edgewood, NM 87015
Phone (505) 437-5085

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X Yes

Addresses

Primary practice location

4127 Montgomery Blvd NE
Albuquerque, NM 87109-1102

Mailing address

4127 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Phone (505) 308-8885

Other identifiers

IdentifierTypeStateIssuer
1164186052OtherNMNPPES

Other names

  • Anderson Family Chiropractic Doing business as
  • Anderson Family Chiropractic of ABQ LLC Former legal business name

Other providers in Albuquerque, NM

All providers in Albuquerque, NM · Chiropractor in New Mexico

Sources for this page

Verify at the official NPI Registry.