East Street Spine & Rehab, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EAST STREET SPINE & REHAB, INC.

Practice address

3786 S East St
Indianapolis, IN 46227-1241

Phone

(317) 791-1511

Fax

(317) 791-1534

NPI assigned

Aug 31, 2010

Last updated

Jul 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shannon RobertsNPI 1235306119

Title

Chiropractor

Phone

(317) 791-1511

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Shannon Roberts, D.C.

  • Chiropractor
  • Indianapolis, IN
  • NPI 1235306119
  Authorized official Same address or phone

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311984000000",
    "number": "1861709693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3786 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271241",
            "telephone_number": "317-791-1511",
            "fax_number": "317-791-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3786 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271241",
            "telephone_number": "317-791-1511",
            "fax_number": "317-791-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST STREET SPINE & REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2011-07-30",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "317-791-1511"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East 53Rd Street Dental-2, P.C. (Kool Smiles)
• East Campus Surgery Center LLC
• East Indianapolis Oral and Maxillofacial Surgery (Steven C. Graham, DDS, Matthew C. Moll, DDS)
• East Indy Dental Care, LLC
• East Side Rheumatology
• East Washington Chiropractic PC
• East Washington Pharmacy LLC
• East Washington Street Dental Indy, in, PC (Pippin Dental)
• East Wind Therapy
• Kim Lynn East, MSW LCSW

• Chiropractor in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2011; 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.