River of Life Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC008772 Issued in PA

Legal business name

RIVER OF LIFE CHIROPRACTIC, INC.

Practice address

2104 Zimmerly Rd
Erie, PA 16509-6213

Phone

(814) 866-2277

Fax

(814) 866-0167

NPI assigned

Feb 11, 2010

Organization subpart

No

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

Authorized official

Name

Tiffany Schreiber

Title

Vice President

Phone

(814) 866-2277

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1740512029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 ZIMMERLY RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165096213",
            "telephone_number": "814-866-2277",
            "fax_number": "814-866-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 ZIMMERLY RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165096213",
            "telephone_number": "814-866-2277",
            "fax_number": "814-866-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER OF LIFE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "SCHREIBER",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "814-866-2277"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PROVIDER ID",
            "identifier": "001366053",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021592930001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.