Organization Active NPI

Island Chiropractic & Rehabilitation, P.a.

  • Chiropractor
  • Galveston, TX
National Provider Identifier
1700945615
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6422 Issued in TX
Legal business name
ISLAND CHIROPRACTIC & REHABILITATION, P.A.
Practice address
2006 45TH Street
Galveston, TX 77550
Phone
(409) 763-5900
Fax
(409) 763-5916
NPI assigned
Dec 6, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Anello John Dambra, D.C.NPI 1104990332
Title
President
Phone
(409) 763-5900

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
Chiropractor 111N00000X 6422 TX Primary

Addresses

Primary practice location

2006 45TH Street
Galveston, TX 77550

Mailing address

2006 45TH Street
Galveston, TX 77550
Phone (409) 763-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040513000759 TX Part B Supplier - Clinic/Group Practice 9436149333 Receives reassigned benefits from 1 practitioner
Practice locations: Galveston, TX

National Provider Directory

National Provider Directory

Locations

2006 45th St
Galveston, TX 77550
Phone (409) 763-5900

Practitioners & affiliated clinicians

Practitioners 2

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": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700945615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 45TH STREET",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "77550",
            "telephone_number": "409-763-5900",
            "fax_number": "409-763-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 45TH STREET",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "77550",
            "telephone_number": "409-763-5900",
            "fax_number": "409-763-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND CHIROPRACTIC & REHABILITATION, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAMBRA",
        "authorized_official_first_name": "ANELLO",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-763-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.