Organization Active NPI

Center for Alternative Medicine, PLLC

  • Chiropractor
  • Pueblo, CO
National Provider Identifier
1831438605
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6677 Issued in CO
Legal business name
CENTER FOR ALTERNATIVE MEDICINE, PLLC
Practice address
2505 Kachina Dr
Pueblo, CO 81008-1573
Phone
(719) 544-2009
Fax
(719) 253-7734
NPI assigned
Feb 13, 2013
Last updated
Jul 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Authorized official

Name
Dr. Theodore W Davis, D.C.NPI 1033400510
Title
Doctor of Chiropractic
Phone
(719) 544-2009

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2788 CO
Chiropractor 111N00000X 6677 CO Primary

Addresses

Primary practice location

2505 Kachina Dr
Pueblo, CO 81008-1573

Mailing address

2505 Kachina Dr
Pueblo, CO 81008-1573
Phone (719) 544-2009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130701000768 CO Part B Supplier - Clinic/Group Practice 2466692124 Receives reassigned benefits from 2 practitioners
Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1831438605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 KACHINA DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081573",
            "telephone_number": "719-544-2009",
            "fax_number": "719-253-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 KACHINA DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081573",
            "telephone_number": "719-544-2009",
            "fax_number": "719-253-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ALTERNATIVE MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-13",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "719-544-2009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "2788",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.