Active NPI
Robert A. Neiderhiser I, D.C.
- Chiropractor
- Bloomsburg, PA
National Provider Identifier
1801889118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC001355L
- Practice address
- 1901 Columbia Blvd
Suite # 4
Bloomsburg, PA 17815-7750 - Phone
- (570) 389-1901
- Fax
- (570) 389-0469
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC001355L | PA | Primary |
Addresses
Primary practice location
1901 Columbia Blvd
Suite # 4
Bloomsburg, PA 17815-7750
Mailing address
1901 Columbia Blvd
Suite # 4
Bloomsburg, PA 17815-7750
Phone (570) 389-1901
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01577401 | Other | PA | CAPITAL BLUE CROSS |
| 000692972 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120223000301 | PA | Practitioner - Chiropractic | 1355509233 | Practice locations: Bloomsburg, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1611 Columbia Blvd
Bloomsburg, PA 17815-8862
Phone (570) 389-1901
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC001355L | PA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334880000000",
"number": "1801889118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 COLUMBIA BLVD",
"address_2": "SUITE # 4",
"city": "BLOOMSBURG",
"state": "PA",
"postal_code": "178157750",
"telephone_number": "570-389-1901",
"fax_number": "570-389-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 COLUMBIA BLVD",
"address_2": "SUITE # 4",
"city": "BLOOMSBURG",
"state": "PA",
"postal_code": "178157750",
"telephone_number": "570-389-1901",
"fax_number": "570-389-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEIDERHISER",
"first_name": "ROBERT",
"middle_name": "A.",
"name_suffix": "I",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2012-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC001355L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01577401",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000692972",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.