NPIMap

Organization Active NPI

Summit Chiropractic & Rehabilitation, P.C.

  • Chiropractor
  • Dillon, CO
National Provider Identifier
1659501435
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2688 Issued in CO
Legal business name
SUMMIT CHIROPRACTIC & REHABILITATION, P.C.
Practice address
114 Village Place
Ste 302
Dillon, CO 80435-0300
Phone
(970) 513-9234
Fax
(970) 513-9238
NPI assigned
Jul 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Dr. Ivo F Waerlop, DC,DABCN, CCSP, CCRDNPI 1154455939
Title
President/Dr.
Phone
(970) 513-9234

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 2688 CO Primary

Addresses

Primary practice location

114 Village Place
Ste 302
Dillon, CO 80435-0300

Mailing address

PO Box 300
114 Village Place Ste 302
Dillon, CO 80435-0300
Phone (970) 513-9234

Other identifiers 2

IdentifierTypeStateIssuer
1154455939OtherCONPI
1013041896OtherCONPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100503000738 CO Part B Supplier - Clinic/Group Practice 8628106291 Receives reassigned benefits from 2 practitioners
Practice locations: Dillon, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1659501435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300",
            "address_2": "114 VILLAGE PLACE STE 302",
            "city": "DILLON",
            "state": "CO",
            "postal_code": "804350300",
            "telephone_number": "970-513-9234",
            "fax_number": "970-513-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 VILLAGE PLACE",
            "address_2": "STE 302",
            "city": "DILLON",
            "state": "CO",
            "postal_code": "804350300",
            "telephone_number": "970-513-9234",
            "fax_number": "970-513-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CHIROPRACTIC & REHABILITATION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "WAERLOP",
        "authorized_official_first_name": "IVO",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT/DR.",
        "authorized_official_telephone_number": "970-513-9234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC,DABCN, CCSP, CCRD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "2688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154455939",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013041896",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.