Organization Active NPI

Community Chiropractic Center

  • Chiropractor
  • Placentia, CA
National Provider Identifier
1821286352
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
COMMUNITY CHIROPRACTIC CENTER
Practice address
1255 E Imperial Hwy
Placentia, CA 92870-1718
Phone
(714) 961-1200
Fax
(714) 961-1388
NPI assigned
Oct 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Dr. Stacey Dee Ellison, D.CNPI 1801923073
Title
Owner
Phone
(714) 961-1200

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 Primary

Addresses

Primary practice location

1255 E Imperial Hwy
Placentia, CA 92870-1718

Mailing address

1255 E Imperial Hwy
Placentia, CA 92870-1718
Phone (714) 961-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120611000301 CA Part B Supplier - Clinic/Group Practice 7315101961 Receives reassigned benefits from 2 practitioners
Practice locations: Placentia, CA

National Provider Directory

National Provider Directory

Locations

1255 E Imperial Hwy
Placentia, CA 92870
Phone (714) 524-6990

Practitioners & affiliated clinicians

Practitioners 3

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": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1821286352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 E IMPERIAL HWY",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928701718",
            "telephone_number": "714-961-1200",
            "fax_number": "714-961-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 E IMPERIAL HWY",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928701718",
            "telephone_number": "714-961-1200",
            "fax_number": "714-961-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-961-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.