NPIMap

Organization Active NPI

Woburn Family Chiropractic, Inc.

  • Chiropractor
  • Woburn, MA
National Provider Identifier
1801937578
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
157 Issued in MA
Legal business name
WOBURN FAMILY CHIROPRACTIC, INC.
Doing business as
North Shore Spine & Rehab
Practice address
20 Cummings Park
Woburn, MA 01801-2122
Phone
(781) 938-9400
Fax
(781) 938-9323
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Dr. Michael Pendolino, D.C.
Title
President
Phone
(781) 938-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 157 MA Primary

Addresses

Primary practice location

20 Cummings Park
Woburn, MA 01801-2122

Mailing address

20 Cummings Park
Woburn, MA 01801-2122
Phone (781) 938-9400

Other identifiers 3

IdentifierTypeStateIssuer
Y39722OtherMABCBS GROUP#
460083OtherMATUFTS
AA7544OtherMAHARVARD PILGRIM HEALTH

Other names 1

  • North Shore Spine & Rehab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Shore Spine Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1801937578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012122",
            "telephone_number": "781-938-9400",
            "fax_number": "781-938-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012122",
            "telephone_number": "781-938-9400",
            "fax_number": "781-938-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOBURN FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "PENDOLINO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-938-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP#",
            "identifier": "Y39722",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "460083",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "AA7544",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Spine & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.