NPIMap

Organization Active NPI

Chestertown Chiropractic Center LLC

  • Chiropractor
  • Chestertown, MD
National Provider Identifier
1801010418
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01718 Issued in MD
Legal business name
CHESTERTOWN CHIROPRACTIC CENTER LLC
Practice address
819B High St
Chestertown, MD 21620-1100
Phone
(410) 810-0530
Fax
(410) 810-0200
NPI assigned
Apr 13, 2007
Last updated
Aug 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Authorized official

Name
Patricia A Fanning, D.C.NPI 1912984204
Title
Owner
Phone
(410) 810-0530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S01718 MD Primary

Addresses

Primary practice location

819B High St
Chestertown, MD 21620-1100

Mailing address

819B High St
Chestertown, MD 21620-1100
Phone (410) 810-0530

Other identifiers 3

IdentifierTypeStateIssuer
M281OtherMDBLUECROSS BLUESHIELD
W4570001OtherMDBLUECROSS BLUESHIELD
S01718OtherMDLICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

103 Dixon Dr
Chestertown, MD 21620
Phone (410) 810-0530

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": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1801010418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819B HIGH ST",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201100",
            "telephone_number": "410-810-0530",
            "fax_number": "410-810-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819B HIGH ST",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201100",
            "telephone_number": "410-810-0530",
            "fax_number": "410-810-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTERTOWN CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "FANNING",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-810-0530",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "M281",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "W4570001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "S01718",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestertown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.