Individual provider Active NPI

Robert E Street, DC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1801939251
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3046 Issued in AZ
Practice address
711 E Carefree Hwy
Ste B-214
Phoenix, AZ 85085-0101
Phone
(623) 582-4252
Fax
(623) 582-4252
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3046 AZ Primary
Chiropractor 111N00000X RS002625 MI

Addresses

Primary practice location

711 E Carefree Hwy
Ste B-214
Phoenix, AZ 85085-0101

Mailing address

711 E Carefree Hwy
Ste B-214
Phoenix, AZ 85085-0101
Phone (623) 582-4252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080527000344 AZ Practitioner - Chiropractic 8022187467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1971
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10505 N 69TH St
Suite 1200
Paradise Valley, AZ 85253-4542
Phone (480) 483-0553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RS002625MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Az Chiro Care, LLC Chiropractor CurrentSince Apr 7, 2008 Accepting new patients

Locations

711 E Carefree Hwy
Ste B214
Phoenix, AZ 85085
Phone (623) 582-4252

10505 N 69th St
Ste 1200
Scottsdale, AZ 85253
Phone (480) 483-0553

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1801939251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E CAREFREE HWY",
            "address_2": "STE B-214",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850850101",
            "telephone_number": "623-582-4252",
            "fax_number": "623-582-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E CAREFREE HWY",
            "address_2": "STE B-214",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850850101",
            "telephone_number": "623-582-4252",
            "fax_number": "623-582-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "3046",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "RS002625",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.

Verify at the official NPI Registry.