Individual provider Active NPI

Nicholas Sean O'Connor, DC

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1659827772
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC33571 Issued in CA
Practice address
5252 Balboa Ave
Suite 701
San Diego, CA 92117-6906
Phone
(858) 384-6556
Fax
(858) 225-8320
NPI assigned
Aug 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC33571 CA Primary

Addresses

Primary practice location

5252 Balboa Ave
Suite 701
San Diego, CA 92117-6906

Mailing address

5252 Balboa Ave
Suite 701
San Diego, CA 92117-6906
Phone (858) 384-6556

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180118001315 CA Practitioner - Chiropractic 3173882289 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC33571CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Llantada Chiropractic a Professional Corporation Chiropractor PastSince Jun 29, 2015 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1659827772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE",
            "address_2": "SUITE 701",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176906",
            "telephone_number": "858-384-6556",
            "fax_number": "858-225-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE",
            "address_2": "SUITE 701",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176906",
            "telephone_number": "858-384-6556",
            "fax_number": "858-225-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "NICHOLAS",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC33571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.