Organization Active NPI

Breath of Life Chiropractic and Wellness

  • Health Maintenance Organization
  • Brockton, MA
National Provider Identifier
1720449093
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
3095 Issued in MA
Legal business name
BREATH OF LIFE CHIROPRACTIC AND WELLNESS
Practice address
146 Briarcliff Rd
Brockton, MA 02301-3011
Phone
(508) 250-7359
NPI assigned
Mar 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Authorized official

Name
Caleb Ultimo, D.C.
Title
Chiropractor
Phone
(508) 250-7359

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 3095 MA Primary

Addresses

Primary practice location

146 Briarcliff Rd
Brockton, MA 02301-3011

Mailing address

92 Torrey St Ste 2
Brockton, MA 02301-4862

National Provider Directory

National Provider Directory

Locations

92 Torrey St
Ste 2
Brockton, MA 02301

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458000000000",
    "number": "1720449093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 TORREY ST STE 2",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 BRIARCLIFF RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013011",
            "telephone_number": "508-250-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREATH OF LIFE CHIROPRACTIC AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A",
        "authorized_official_last_name": "ULTIMO",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "508-250-7359",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MA",
            "license": "3095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.