Organization Active NPI

Cocain Chiropractic Corporation

  • Chiropractor
  • Ventura, CA
National Provider Identifier
1629149281
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC9841 Issued in CA
Legal business name
COCAIN CHIROPRACTIC CORPORATION
Practice address
4247 Telegraph Rd
Ventura, CA 93003-3705
Phone
(805) 644-5563
Fax
(805) 644-3430
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Robert V Cocain, DCNPI 1124217534
Title
Owner
Phone
(805) 644-5563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC9841 CA Primary

Addresses

Primary practice location

4247 Telegraph Rd
Ventura, CA 93003-3705

Mailing address

4247 Telegraph Rd
Ventura, CA 93003-3705
Phone (805) 644-5563

Other identifiers 1

IdentifierTypeStateIssuer
DC0098410MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081024000191 CA Part B Supplier - Clinic/Group Practice 4587722277 Receives reassigned benefits from 1 practitioner
Practice locations: Ventura, CA

National Provider Directory

National Provider Directory

Locations

4247 Telegraph Rd
Ventura, CA 93003
Phone (805) 644-5563

Practitioners & affiliated clinicians

Practitioners 7

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1629149281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4247 TELEGRAPH RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033705",
            "telephone_number": "805-644-5563",
            "fax_number": "805-644-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4247 TELEGRAPH RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033705",
            "telephone_number": "805-644-5563",
            "fax_number": "805-644-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCAIN CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "COCAIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-644-5563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC9841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0098410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.