Individual provider Active NPI

Thomas A Basile, D.C.

  • Chiropractor
  • Johnstown, PA
National Provider Identifier
1619051638
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002606L Issued in PA
Practice address
1837 Goucher St
Suite 1
Johnstown, PA 15905-9506
Phone
(814) 255-7292
Fax
(814) 255-6742
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC002606L PA Primary

Addresses

Primary practice location

1837 Goucher St
Suite 1
Johnstown, PA 15905-9506

Mailing address

1837 Goucher St
Suite 1
Johnstown, PA 15905-9506
Phone (814) 255-7292

Other identifiers 1

IdentifierTypeStateIssuer
0009445410003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC002606LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Laurel Chiropractic Associates Chiropractor Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619051638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 GOUCHER ST",
            "address_2": "SUITE 1",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159059506",
            "telephone_number": "814-255-7292",
            "fax_number": "814-255-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1837 GOUCHER ST",
            "address_2": "SUITE 1",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159059506",
            "telephone_number": "814-255-7292",
            "fax_number": "814-255-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASILE",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002606L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009445410003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.