Team Chiromed, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC4940 Issued in AZ

Legal business name

TEAM CHIROMED, INC.

Practice address

3434 W Greenway Rd Ste 107
Phoenix, AZ 85053-3886

Phone

(602) 866-9285

NPI assigned

Sep 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Peter M. Wistort, D.C.NPI 1932205549

Title

Owner/Operator

Phone

(602) 866-9285

Specialties & licenses 1

Addresses

Other names 1

• Team Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter M Wistort, D.C.

  • Chiropractor
  • Phoenix, AZ
  • NPI 1932205549
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1780870204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 W GREENWAY RD STE 107",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850533886",
            "telephone_number": "602-866-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 W GREENWAY RD STE 107",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850533886",
            "telephone_number": "602-866-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM CHIROMED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "WISTORT",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "602-866-9285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "DC4940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Team Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.