Organization Active NPI

Northern Chiropractic, PC

  • Chiropractor
  • Eagle River, AK
National Provider Identifier
1710076856
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
294545 Issued in AK
Legal business name
NORTHERN CHIROPRACTIC, PC
Practice address
11723 Old Glenn Hwy #101
Eagle River, AK 99577-7749
Phone
(907) 696-4878
Fax
(907) 696-4674
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Gregory M Culbert, DC, DABCONPI 1740494863
Title
President/Owner
Phone
(907) 696-4878

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 294545 AK Primary

Addresses

Primary practice location

11723 Old Glenn Hwy #101
Eagle River, AK 99577-7749

Mailing address

11723 Old Glenn Hwy #101
Eagle River, AK 99577-7749
Phone (907) 696-4878

Other identifiers 1

IdentifierTypeStateIssuer
CH0245MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110127001138 AK Part B Supplier - Clinic/Group Practice 3779472519 Receives reassigned benefits from 1 practitioner
Practice locations: Eagle River, AK

National Provider Directory

National Provider Directory

Locations

11723 Old Glenn Hwy
Ste 101
Eagle River, AK 99577
Phone (907) 696-4878

Interoperability endpoints

  • Direct secure messaging: agreg@ncp0003.direct.chirotouch.md

Practitioners & affiliated clinicians

Practitioners 4

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1710076856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11723 OLD GLENN HWY #101",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777749",
            "telephone_number": "907-696-4878",
            "fax_number": "907-696-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11723 OLD GLENN HWY #101",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777749",
            "telephone_number": "907-696-4878",
            "fax_number": "907-696-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "CULBERT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "907-696-4878",
        "authorized_official_credential": "DC, DABCO"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "294545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0245",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.