Individual provider Active NPI

Phillip James Pokorny, D.C.

  • Chiropractor
  • Apache Junction, AZ
National Provider Identifier
1699889097
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5604 Issued in AZ
Practice address
110 S Idaho Rd
Suite 140
Apache Junction, AZ 85219-2379
Phone
(480) 671-5655
Fax
(480) 617-5705
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5604 AZ Primary

Addresses

Primary practice location

110 S Idaho Rd
Suite 140
Apache Junction, AZ 85219-2379

Mailing address

110 S Idaho Rd
Suite 140
Apache Junction, AZ 85219-2379
Phone (480) 671-5655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000783 AZ Practitioner - Chiropractic 2567449713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 S Idaho Rd
Suite 140
Apache Junction, AZ 85119-2379
Phone (480) 671-5655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5604AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Healthcare LLC CurrentSince Oct 30, 2012 Accepting new patients
Aligned 2021 CurrentSince Oct 3, 2003 Accepting new patients

Locations

110 S Idaho Rd
Ste 140
Apache Junction, AZ 85119
Phone (480) 671-5655

Organizations & group practices 2

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1699889097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S IDAHO RD",
            "address_2": "SUITE 140",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852192379",
            "telephone_number": "480-671-5655",
            "fax_number": "480-617-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S IDAHO RD",
            "address_2": "SUITE 140",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852192379",
            "telephone_number": "480-671-5655",
            "fax_number": "480-617-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKORNY",
        "first_name": "PHILLIP",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.