NPIMap

Organization Active NPI

Red Lion Chiropractic Center, PC

  • Chiropractor
  • Philadelphia, PA
National Provider Identifier
1861732463
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006295L Issued in PA
Legal business name
RED LION CHIROPRACTIC CENTER, PC
Practice address
842 Red Lion Rd
#8
Philadelphia, PA 19115-1475
Phone
(215) 464-0404
Fax
(215) 464-0683
NPI assigned
Feb 20, 2013
Last updated
Feb 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Dr. Larisa Granovsky, DCNPI 1285620757
Title
President
Phone
(215) 464-0404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC006295L PA Primary

Addresses

Primary practice location

842 Red Lion Rd
#8
Philadelphia, PA 19115-1475

Mailing address

842 Red Lion Rd
#8
Philadelphia, PA 19115-1475
Phone (215) 464-0404

Other identifiers 1

IdentifierTypeStateIssuer
0015288270001MedicaidPA

National Provider Directory

National Provider Directory

Locations

842 Red Lion Rd
Ste 8
Philadelphia, PA 19115
Phone (215) 464-0404

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1861732463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 RED LION RD",
            "address_2": "#8",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151475",
            "telephone_number": "215-464-0404",
            "fax_number": "215-464-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 RED LION RD",
            "address_2": "#8",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151475",
            "telephone_number": "215-464-0404",
            "fax_number": "215-464-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED LION CHIROPRACTIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "GRANOVSKY",
        "authorized_official_first_name": "LARISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-464-0404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006295L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015288270001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.