Organization Active NPI

Dover Chiropractic, LLC

  • Chiropractor
  • Baltimore, MD
National Provider Identifier
1669726964
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03464 Issued in MD
Legal business name
DOVER CHIROPRACTIC, LLC
Practice address
6600 York Rd
Suite107
Baltimore, MD 21212-2028
Phone
(410) 377-3070
Fax
(410) 377-2960
NPI assigned
Nov 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Authorized official

Name
Dr. Laura Bradford Dover, D.C.NPI 1760787782
Title
Owner/Doctor
Phone
(410) 377-3070

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X S03464 MD Primary

Addresses

Primary practice location

6600 York Rd
Suite107
Baltimore, MD 21212-2028

Mailing address

6600 York Rd
Suite107
Baltimore, MD 21212-2028
Phone (410) 377-3070

Other identifiers 1

IdentifierTypeStateIssuer
S03464OtherMDCHIROPRACTIC LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121206000520 MD Part B Supplier - Clinic/Group Practice 1153573605 Receives reassigned benefits from 1 practitioner
Practice locations: Towson, MD

National Provider Directory

National Provider Directory

Locations

6600 York Rd
Ste 107
Baltimore, MD 21212
Phone (410) 377-3070

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": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1669726964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 YORK RD",
            "address_2": "SUITE107",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122028",
            "telephone_number": "410-377-3070",
            "fax_number": "410-377-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 YORK RD",
            "address_2": "SUITE107",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122028",
            "telephone_number": "410-377-3070",
            "fax_number": "410-377-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVER CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "DOVER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "BRADFORD",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "410-377-3070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "S03464",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.