Individual provider Active NPI

Corey Richard Crochiere, D.C.

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1871691972
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC30143 Issued in CA
Practice address
1101 S Winchester Blvd Ste J210
San Jose, CA 95128-3904
Phone
(408) 564-7820
Fax
(408) 564-7848
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC30143 CA Primary

Addresses

Primary practice location

1101 S Winchester Blvd Ste J210
San Jose, CA 95128-3904

Mailing address

1101 S Winchester Blvd Ste J210
San Jose, CA 95128-3904
Phone (408) 564-7820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC30143CAMDChiropractor
30143CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wang Chiropractic Chiropractor Past Accepting new patients
Tuong Mai Chiropractic Inc Chiropractor PastSince Nov 3, 2019 Accepting new patients

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1871691972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S WINCHESTER BLVD STE J210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283904",
            "telephone_number": "408-564-7820",
            "fax_number": "408-564-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S WINCHESTER BLVD STE J210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283904",
            "telephone_number": "408-564-7820",
            "fax_number": "408-564-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCHIERE",
        "first_name": "COREY",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.