Pro-Active Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1415 Issued in NM

Legal business name

PRO-ACTIVE CHIROPRACTIC LLC

Practice address

1892A Plaza del Sur Dr
Santa Fe, NM 87505-6043

Phone

(505) 984-0934

Fax

(505) 988-8018

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Peter W. Unverferth, DCNPI 1568565125

Title

Owner

Phone

(505) 984-0934

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter W Unverferth

  • Chiropractor
  • Santa Fe, NM
  • NPI 1568565125
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1669690095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1892A PLAZA DEL SUR DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056043",
            "telephone_number": "505-984-0934",
            "fax_number": "505-988-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1892A PLAZA DEL SUR DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056043",
            "telephone_number": "505-984-0934",
            "fax_number": "505-988-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-ACTIVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "UNVERFERTH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-984-0934",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Chiropractor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.