Organization Active NPI

Brock Chiropractic Wellness Center, Inc.

  • Chiropractor
  • Redondo Beach, CA
National Provider Identifier
1710059100
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26349 Issued in CA
Legal business name
BROCK CHIROPRACTIC WELLNESS CENTER, INC.
Practice address
1426 Aviation Blvd
Suite 202
Redondo Beach, CA 90278-4002
Phone
(310) 698-4638
Fax
(310) 698-0978
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Authorized official

Name
Dr. Aprilyn Ann Stitt, D.C.NPI 1881971844
Title
Owner
Phone
(310) 698-4638

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC26349 CA Primary

Addresses

Primary practice location

1426 Aviation Blvd
Suite 202
Redondo Beach, CA 90278-4002

Mailing address

1426 Aviation Blvd
Suite 202
Redondo Beach, CA 90278-4002
Phone (310) 698-4638

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120309000560 CA Part B Supplier - Clinic/Group Practice 0042479099 Receives reassigned benefits from 1 practitioner
Practice locations: Redondo Beach, CA

National Provider Directory

National Provider Directory

Locations

1426 Aviation Blvd
Ste 202
Redondo Beach, CA 90278
Phone (310) 344-5041

Practitioners & affiliated clinicians

Practitioners 1

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1710059100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 AVIATION BLVD",
            "address_2": "SUITE 202",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784002",
            "telephone_number": "310-698-4638",
            "fax_number": "310-698-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 AVIATION BLVD",
            "address_2": "SUITE 202",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784002",
            "telephone_number": "310-698-4638",
            "fax_number": "310-698-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCK CHIROPRACTIC WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "STITT",
        "authorized_official_first_name": "APRILYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-698-4638",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.