Organization Active NPI

Huffman Chiropractic, PLLC

  • Chiropractor
  • Lake Havasu City, AZ
National Provider Identifier
1649350604
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5112 Issued in AZ
Legal business name
HUFFMAN CHIROPRACTIC, PLLC
Practice address
1695 Mesquite Ave Ste 114
Lake Havasu City, AZ 86403-5647
Phone
(928) 453-6808
Fax
(928) 453-8485
NPI assigned
Oct 16, 2006
Last updated
Oct 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Dr. Paul Shannon Huffman, DCNPI 1184637373
Title
Owner/Partner
Phone
(928) 453-6808

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 5112 AZ Primary

Addresses

Primary practice location

1695 Mesquite Ave Ste 114
Lake Havasu City, AZ 86403-5647

Mailing address

1695 Mesquite Ave Ste 114
Lake Havasu City, AZ 86403-5647
Phone (928) 453-6808

Other identifiers 2

IdentifierTypeStateIssuer
AZ0935770OtherAZBCBS AZ
1Z1452OtherAZHEALTH NET

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040615000687 AZ Part B Supplier - Clinic/Group Practice 5193709467 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Havasu City, AZ

National Provider Directory

National Provider Directory

Locations

1695 Mesquite Ave
Ste 114
Lk Havasu Cty, AZ 86403
Phone (928) 453-6808

1930 Mesquite Ave
Ste 2
Lk Havasu Cty, AZ 86403
Phone (928) 854-7962

Practitioners & affiliated clinicians

Practitioners 6

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": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1649350604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 MESQUITE AVE STE 114",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035647",
            "telephone_number": "928-453-6808",
            "fax_number": "928-453-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 MESQUITE AVE STE 114",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035647",
            "telephone_number": "928-453-6808",
            "fax_number": "928-453-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUFFMAN CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "HUFFMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "928-453-6808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ",
            "identifier": "AZ0935770",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "1Z1452",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

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