Organization Active NPI

Blakemore California Chiropractic Office, Inc.

  • Orthopedic Chiropractor
  • Fullerton, CA
National Provider Identifier
1790081537
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
DC12131 Issued in CA
Legal business name
BLAKEMORE CALIFORNIA CHIROPRACTIC OFFICE, INC.
Practice address
159 N Raymond Ave
Fullerton, CA 92831-4609
Phone
(714) 871-2495
Fax
(714) 871-3350
NPI assigned
Jan 26, 2011
Last updated
Jan 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Authorized official

Name
Dr. James G Blakemore, D.C.NPI 1194879254
Title
President
Phone
(714) 871-2495

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
Orthopedic Chiropractor 111NX0800X DC12131 CA Primary

Addresses

Primary practice location

159 N Raymond Ave
Fullerton, CA 92831-4609

Mailing address

159 N Raymond Ave
Fullerton, CA 92831-4609
Phone (714) 871-2495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170308000549 CA Part B Supplier - Clinic/Group Practice 1557645751 Receives reassigned benefits from 1 practitioner
Practice locations: Fullerton, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1790081537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 N RAYMOND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314609",
            "telephone_number": "714-871-2495",
            "fax_number": "714-871-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 N RAYMOND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314609",
            "telephone_number": "714-871-2495",
            "fax_number": "714-871-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKEMORE CALIFORNIA CHIROPRACTIC OFFICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "BLAKEMORE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-871-2495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "DC12131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.