Individual provider Active NPI

William J Haneline, D.C.

  • Chiropractor
  • Lake Elsinore, CA
National Provider Identifier
1619980075
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13327 Issued in CA
Practice address
600 Central Ave
Suite G
Lake Elsinore, CA 92530-2740
Phone
(951) 595-1502
Fax
(951) 746-2332
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13327 CA Primary

Addresses

Primary practice location

600 Central Ave
Suite G
Lake Elsinore, CA 92530-2740

Mailing address

600 Central Ave
Suite G
Lake Elsinore, CA 92530-2740
Phone (951) 595-1502

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140616001347 CA Practitioner - Chiropractic 7911004619 Practice locations: Lake Elsinore, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 Central Ave
Suite G
Lake Elsinore, CA 92530-2740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13327CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1619980075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CENTRAL AVE",
            "address_2": "SUITE G",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302740",
            "telephone_number": "951-595-1502",
            "fax_number": "951-746-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CENTRAL AVE",
            "address_2": "SUITE G",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302740",
            "telephone_number": "951-595-1502",
            "fax_number": "951-746-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANELINE",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "13327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.