Individual provider Active NPI

David C Shaffer, DC

  • Chiropractor
  • Riverside, CA
National Provider Identifier
1700893161
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27166 Issued in CA
Practice address
7065 Indiana Ave Ste 110
Riverside, CA 92506-4167
Phone
(951) 476-0115
Fax
(951) 476-0116
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 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 27166 CA Primary

Addresses

Primary practice location

7065 Indiana Ave Ste 110
Riverside, CA 92506-4167

Mailing address

7065 Indiana Ave Ste 110
Riverside, CA 92506-4167
Phone (951) 476-0115

Other practice location 1

12830 Hesperia Rd Ste Cde
Victorville, CA 92395-7788
Phone (760) 684-8999

Other practice location 2

17450 Main St Ste D-101
Hesperia, CA 92345-6298
Phone (760) 493-2929

Other identifiers 1

IdentifierTypeStateIssuer
0104556356OtherVAVIRGINIA STATE LICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150210002354 CA Practitioner - Chiropractic 5395840748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Moeller-Bertram Medical Corporation CurrentSince May 1, 2025 Accepting new patients
Nova Spine & Injury Center, Inc. Chiropractor PastSince Sep 1, 2006 Accepting new patients

Locations

44630 Monterey Ave
Ste 100
Palm Desert, CA 92260
Phone (760) 340-4290

36101 Bob Hope Dr
Ste A1
Rancho Mirage, CA 92270
Phone (760) 321-1315

7065 Indiana Ave
Ste 100
Riverside, CA 92506
Phone (951) 476-0115

1695 S San Jacinto Ave
Ste A
San Jacinto, CA 92583
Phone (951) 330-3100

12640 Hesperia Rd
Ste D
Victorville, CA 92395
Phone (760) 684-4143

12830 Hesperia Rd
Ste Ad
Victorville, CA 92395
Phone (760) 684-8999

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1700893161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7065 INDIANA AVE STE 110",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064167",
            "telephone_number": "951-476-0115",
            "fax_number": "703-738-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7065 INDIANA AVE STE 110",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064167",
            "telephone_number": "951-476-0115",
            "fax_number": "951-476-0116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12830 Hesperia Rd Ste Cde",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923957788",
            "country_code": "US",
            "telephone_number": "760-684-8999",
            "fax_number": "760-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17450 Main St Ste D-101",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923456298",
            "country_code": "US",
            "telephone_number": "760-493-2929",
            "fax_number": "760-493-2922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "27166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA STATE LICENSE #",
            "identifier": "0104556356",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.