Organization Active NPI

Cameron J.P. Sembaluk, D.C.,P.C

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1730480567
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6060 Issued in AZ
Legal business name
CAMERON J.P. SEMBALUK, D.C.,P.C
Practice address
1954 S Dobson Rd
Suite 3
Mesa, AZ 85202-5660
Phone
(480) 345-2022
Fax
(480) 345-0022
NPI assigned
Nov 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Authorized official

Name
Dr. Cameron JP SembalukNPI 1497711923
Title
Owner
Phone
(480) 345-2022

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 6060 AZ Primary

Addresses

Primary practice location

1954 S Dobson Rd
Suite 3
Mesa, AZ 85202-5660

Mailing address

1954 S Dobson Rd
Suite 3
Mesa, AZ 85202-5660
Phone (480) 345-2022

Other names 1

  • Dobson Bay Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110117000056 AZ Part B Supplier - Clinic/Group Practice 8224227681 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Locations

1954 S Dobson Rd
Ste 3
Mesa, AZ 85202
Phone (480) 345-2022

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": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1730480567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 S DOBSON RD",
            "address_2": "SUITE 3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025660",
            "telephone_number": "480-345-2022",
            "fax_number": "480-345-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 S DOBSON RD",
            "address_2": "SUITE 3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025660",
            "telephone_number": "480-345-2022",
            "fax_number": "480-345-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMERON J.P. SEMBALUK, D.C.,P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "SEMBALUK",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_middle_name": "JP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-345-2022",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "6060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dobson Bay Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.