Organization Active NPI

Abundant Life Chiropractic

  • Chiropractor
  • Waterford, PA
National Provider Identifier
1619168499
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC8650 Issued in PA
Legal business name
ABUNDANT LIFE CHIROPRACTIC
Practice address
9070 Peach St
Suite #1
Waterford, PA 16441-4078
Phone
(814) 866-1933
Fax
(814) 866-1934
NPI assigned
Aug 6, 2007
Last updated
Aug 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Authorized official

Name
Andrew Thomas Pamer, D.C.
Title
Chiropractor
Phone
(814) 866-1933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC8650 PA Primary

Addresses

Primary practice location

9070 Peach St
Suite #1
Waterford, PA 16441-4078

Mailing address

9070 Peach St
Suite #1
Waterford, PA 16441-4078
Phone (814) 866-1933

Other identifiers 1

IdentifierTypeStateIssuer
1014200490001MedicaidPA

National Provider Directory

National Provider Directory

Locations

9070 Peach St
Ste 1
Waterford, PA 16441
Phone (814) 866-1933

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1619168499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 PEACH ST",
            "address_2": "SUITE #1",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164414078",
            "telephone_number": "814-866-1933",
            "fax_number": "814-866-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 PEACH ST",
            "address_2": "SUITE #1",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164414078",
            "telephone_number": "814-866-1933",
            "fax_number": "814-866-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "PAMER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "814-866-1933",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC8650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014200490001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, PA

Sources for this page

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