Organization Active NPI

Backpro Chiropractic & Nutrition, P.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1639422611
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5719 Issued in AZ
Legal business name
BACKPRO CHIROPRACTIC & NUTRITION, P.C.
Practice address
3141 E Beardsley Rd
Suite 125
Phoenix, AZ 85050-4771
Phone
(602) 992-4444
Fax
(602) 992-4004
NPI assigned
Oct 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Authorized official

Name
Richard A Guarino, D.C,NPI 1033182266
Title
President/Owner
Phone
(602) 992-4444

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 5719 AZ Primary

Addresses

Primary practice location

3141 E Beardsley Rd
Suite 125
Phoenix, AZ 85050-4771

Mailing address

PO Box 72959
Phoenix, AZ 85050-1033
Phone (602) 992-4444

Other identifiers 2

IdentifierTypeStateIssuer
AZ0934900OtherBCBS OF AZ
Z60382OtherMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130227000603 AZ Part B Supplier - Clinic/Group Practice 8820243603 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

3141 E Beardsley Rd
Ste 125
Phoenix, AZ 85050
Phone (602) 992-4444

Practitioners & affiliated clinicians

Practitioners 1

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": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1639422611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72959",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850501033",
            "telephone_number": "602-992-4444",
            "fax_number": "602-992-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 E BEARDSLEY RD",
            "address_2": "SUITE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504771",
            "telephone_number": "602-992-4444",
            "fax_number": "602-992-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACKPRO CHIROPRACTIC & NUTRITION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "GUARINO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "602-992-4444",
        "authorized_official_credential": "D.C,"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AZ",
            "identifier": "AZ0934900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z60382",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.