NPIMap

Organization Active NPI

Petrey Chiropractic, LLC

  • Chiropractor
  • Mobile, AL
National Provider Identifier
1679196919
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PETREY CHIROPRACTIC, LLC
Practice address
1516 Schillinger Road South
Mobile, AL 36695
Phone
(251) 635-1224
Fax
(251) 635-0911
NPI assigned
May 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Authorized official

Name
Dr. Wilfred Darrell Petrey, DC
Title
Doctor/Owner
Phone
(251) 635-1224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1516 Schillinger Road South
Mobile, AL 36695

Mailing address

1516 Schillinger Road South
Mobile, AL 36695
Phone (251) 635-1224

Other identifiers 1

IdentifierTypeStateIssuer
102I350926MedicaidAL

Other names 1

  • Schillinger Road Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

1516 Schillinger Rd S
Mobile, AL 36695
Phone (251) 635-1224

Practitioners & affiliated clinicians

Practitioners 2

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": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1679196919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 SCHILLINGER ROAD SOUTH",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36695",
            "telephone_number": "251-635-1224",
            "fax_number": "251-635-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 SCHILLINGER ROAD SOUTH",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36695",
            "telephone_number": "251-635-1224",
            "fax_number": "251-635-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETREY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "PETREY",
        "authorized_official_first_name": "WILFRED",
        "authorized_official_middle_name": "DARRELL",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "251-635-1224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102I350926",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Schillinger Road Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Schillinger Road Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.