Active NPI
David C Shaffer, DC
- Chiropractor
- Riverside, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 27166
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0104556356 | Other | VA | VIRGINIA STATE LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moeller-Bertram Medical Corporation | Current | Accepting new patients | |
| Nova Spine & Injury Center, Inc. | Chiropractor | Past | 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.
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- NPI 1902911290
-
- Pain Medicine Physician
- Rancho Mirage, CA
- NPI 1699586388
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.