Individual provider Active NPI

Daniel W Talley, D.C.

  • Chiropractor
  • Lake Havasu City, AZ
National Provider Identifier
1831288331
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7202 Issued in AZ
Practice address
30 Acoma Blvd S Ste 203
Lake Havasu City, AZ 86403-5920
Phone
(928) 680-9500
Fax
(928) 680-9500
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7202 AZ Primary

Addresses

Primary practice location

30 Acoma Blvd S Ste 203
Lake Havasu City, AZ 86403-5920

Mailing address

1116 Kibbey Dr
Lake Havasu City, AZ 86404-2155
Phone (928) 855-9605

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421000063 AZ Practitioner - Chiropractic 9234124066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manipulators IncGroup PAC ID 7618962440, 2 clinicians

Practice addresses (Care Compare)

30 Acoma Blvd S
Suite 203
Lake Havasu City, AZ 86403-5920
Phone (928) 680-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Manipulators Inc Chiropractor CurrentSince Jan 22, 2004 Accepting new patients
Louis a. King D.C.P.C. Chiropractor PastSince Jan 22, 2004 Accepting new patients
Huffman Chiropractic, PLLC Chiropractor PastSince Jul 1, 2002 Accepting new patients

Locations

1678 McCulloch Blvd N
Lake Havasu City, AZ 86403
Phone (928) 680-9500

30 Acoma Blvd S
Ste 203
Lk Havasu Cty, AZ 86403
Phone (928) 680-9500

Organizations & group practices 3

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1831288331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 KIBBEY DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864042155",
            "telephone_number": "928-855-9605",
            "fax_number": "928-680-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ACOMA BLVD S STE 203",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035920",
            "telephone_number": "928-680-9500",
            "fax_number": "928-680-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "DANIEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.