Organization Active NPI

Heal Chiropractic & Wellness

  • Chiropractor
  • Crofton, MD
National Provider Identifier
1679097505
Registry record updated Aug 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03843 Issued in MD
Legal business name
HEAL CHIROPRACTIC & WELLNESS
Practice address
1641 RT 3 North
203
Crofton, MD 21114
Phone
(202) 630-4155
NPI assigned
Aug 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2017

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

Authorized official

Name
Dr. Ndidi I Harley, D.C.NPI 1093011611
Title
Chiropractor/Owner
Phone
(202) 378-3870

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 S03843 MD Primary

Addresses

Primary practice location

1641 RT 3 North
203
Crofton, MD 21114

Mailing address

15309 Littleton PL
Upper Marlboro, MD 20774-9053
Phone (202) 378-3870

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200928000099 MD Part B Supplier - Clinic/Group Practice 5395164222 Receives reassigned benefits from 1 practitioner
Practice locations: Crofton, MD

National Provider Directory

National Provider Directory

Locations

1641 State Route 3 N
Ste 203
Crofton, MD 21114
Phone (202) 630-4155

2101 Concord Blvd
Ste E
Crofton, MD 21114
Phone (202) 378-3870

Practitioners & affiliated clinicians

Practitioners 1

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": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501632000000",
    "number": "1679097505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15309 LITTLETON PL",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207749053",
            "telephone_number": "202-378-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 RT 3 NORTH",
            "address_2": "203",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "21114",
            "telephone_number": "202-630-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAL CHIROPRACTIC & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2017-08-02",
        "status": "A",
        "authorized_official_last_name": "HARLEY",
        "authorized_official_first_name": "NDIDI",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "202-378-3870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; 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.