Organization Active NPI

Well Adjusted Chiropractic Center PC

  • Chiropractor
  • Wellsboro, PA
National Provider Identifier
1639369606
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AJ008927 Issued in PA
Legal business name
WELL ADJUSTED CHIROPRACTIC CENTER PC
Practice address
82 East Avenue
Wellsboro, PA 16901
Phone
(570) 724-2255
Fax
(570) 724-5110
NPI assigned
Jul 26, 2007
Last updated
Oct 24, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
WELL ADJUSTED CHIROPRACTIC CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Dr. Joseph G Iaquinto, DCNPI 1336170364
Title
President
Phone
(570) 724-2255

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
Chiropractor 111N00000X AJ008927 PA Primary

Addresses

Primary practice location

82 East Avenue
Wellsboro, PA 16901

Mailing address

82 East Avenue
Wellsboro, PA 16901
Phone (570) 724-2255

Other identifiers 1

IdentifierTypeStateIssuer
0009691200002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071108000510 PA Part B Supplier - Clinic/Group Practice 6901994938 Receives reassigned benefits from 1 practitioner
Practice locations: Wellsboro, PA

National Provider Directory

National Provider Directory
Part of
Well Adjusted Chiropractic Center PC

Locations

82 East Ave
Wellsboro, PA 16901
Phone (570) 724-2255

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": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1639369606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 EAST AVENUE",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "16901",
            "telephone_number": "570-724-2255",
            "fax_number": "570-723-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 EAST AVENUE",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "16901",
            "telephone_number": "570-724-2255",
            "fax_number": "570-724-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL ADJUSTED CHIROPRACTIC CENTER PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELL ADJUSTED CHIROPRACTIC CENTER",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "IAQUINTO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-724-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "AJ008927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009691200002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellsboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.