Organization Active NPI

Cordima Chiropractic Center, P.C.

  • Chiropractor
  • Somerville, MA
National Provider Identifier
1790907046
Registry record updated Nov 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1349 Issued in MA
Legal business name
CORDIMA CHIROPRACTIC CENTER, P.C.
Practice address
690 Broadway
Somerville, MA 02144-2220
Phone
(617) 629-2600
Fax
(617) 666-9302
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2012

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

Authorized official

Name
Dr. Christopher Thomas CordimaNPI 1962624304
Title
President
Phone
(617) 629-2600

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 1349 MA Primary

Addresses

Primary practice location

690 Broadway
Somerville, MA 02144-2220

Mailing address

168 Summer Ave
Reading, MA 01867-2824
Phone (781) 944-3290

Other identifiers 3

IdentifierTypeStateIssuer
2865499OtherMAAETNA GROUP#
687850OtherMATUFTS GROUP#
Y39639OtherMABCBS GROUP#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000109 MA Part B Supplier - Clinic/Group Practice 8224081443 Receives reassigned benefits from 1 practitioner
Practice locations: Somerville, MA

National Provider Directory

National Provider Directory

Locations

690 Broadway
Somerville, MA 02144
Phone (617) 629-2600

707 Broadway
Somerville, MA 02144

Practitioners & affiliated clinicians

Practitioners 2

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352851200000",
    "number": "1790907046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 SUMMER AVE",
            "city": "READING",
            "state": "MA",
            "postal_code": "018672824",
            "telephone_number": "781-944-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 BROADWAY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442220",
            "telephone_number": "617-629-2600",
            "fax_number": "617-666-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDIMA CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2012-11-14",
        "status": "A",
        "authorized_official_last_name": "CORDIMA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-629-2600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP#",
            "identifier": "2865499",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS GROUP#",
            "identifier": "687850",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP#",
            "identifier": "Y39639",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; 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.