Organization Active NPI

Heritage Chiropractic Center, LLC

  • Chiropractor
  • Las Cruces, NM
National Provider Identifier
1619138807
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1581 Issued in NM
Legal business name
HERITAGE CHIROPRACTIC CENTER, LLC
Practice address
755 S Telshor Blvd
Suite R-102
Las Cruces, NM 88011-4688
Phone
(575) 532-1116
NPI assigned
Jun 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Authorized official

Name
Dr. John K Nelson, DC
Title
Doctor of Chiropractic
Phone
(575) 532-1116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1581 NM Primary

Addresses

Primary practice location

755 S Telshor Blvd
Suite R-102
Las Cruces, NM 88011-4688

Mailing address

755 S Telshor Blvd
Suite R-102
Las Cruces, NM 88011-4688
Phone (575) 532-1116

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090428000246 NM Part B Supplier - Clinic/Group Practice 8527116748 Receives reassigned benefits from 1 practitioner
Practice locations: Las Cruces, NM

National Provider Directory

National Provider Directory

Locations

755 S Telshor Blvd
Ste R102
Las Cruces, NM 88011
Phone (505) 522-5666

Practitioners & affiliated clinicians

Practitioners 2

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": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1619138807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S TELSHOR BLVD",
            "address_2": "SUITE R-102",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114688",
            "telephone_number": "575-532-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S TELSHOR BLVD",
            "address_2": "SUITE R-102",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114688",
            "telephone_number": "575-532-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "575-532-1116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.