Genesis Performance Chiropractic, LLC
Organization Active NPI Chiropractor · Elverson, PA
NPI 1770901787 · NPPES record last updated Apr 7, 2014
Key facts
- NPI
- 1770901787
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC010795 (PA)
- Legal business name
- GENESIS PERFORMANCE CHIROPRACTIC, LLC
- Practice address
- 102 S Pine St
Elverson, PA 19520-9241 - Phone
- (610) 286-9991
- Fax
- (610) 286-0265
- NPI assigned
- Apr 7, 2014
- Organization subpart
- No
Authorized official
- Name
- Ryan Vermeesch, DC
- Title
- Owner
- Phone
- (484) 941-4345
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140522000280 | PA | Part B Supplier - Clinic/Group Practice | 7618190513 |
Receives reassigned benefits from 1 practitioner Practice locations: Elverson, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | DC010795 | PA | Yes |
Addresses
Primary practice location
102 S Pine St
Elverson, PA 19520-9241
Mailing address
102 S Pine St
Elverson, PA 19520-9241
Phone (610) 286-9991
Other providers in Elverson, PA
- Focusedhealth PC
- Jennifer S Fronda
- Joseph Funari
- Lisa Ann Gallagher
- Margaret Jeanette Gebert
- Christopher Joel Hampton
- Lori Haraschak
- Healthatlantic LLC
- Grace Heckman
- Amanda S Hurley Roberts
All providers in Elverson, PA · Chiropractor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.