Organization Active NPI

Southern York County Chiropractic

  • Chiropractor
  • Glen Rock, PA
National Provider Identifier
1891810040
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007378L Issued in PA
Legal business name
SOUTHERN YORK COUNTY CHIROPRACTIC
Practice address
40 Water St
Glen Rock, PA 17327-1011
Phone
(717) 235-8855
Fax
(717) 235-8850
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Authorized official

Name
Dr. David Wells, D.C.NPI 1679612659
Title
President
Phone
(717) 235-8855

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC007378L PA Primary

Addresses

Primary practice location

40 Water St
Glen Rock, PA 17327-1011

Mailing address

40 Water St
Glen Rock, PA 17327-1011
Phone (717) 235-8855

Other identifiers 1

IdentifierTypeStateIssuer
SO1351319OtherPAPA BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120412000107 PA Part B Supplier - Clinic/Group Practice 8628239050 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Rock, PA

National Provider Directory

National Provider Directory

Locations

40 Water St
Glen Rock, PA 17327
Phone (717) 235-8855

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1891810040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WATER ST",
            "city": "GLEN ROCK",
            "state": "PA",
            "postal_code": "173271011",
            "telephone_number": "717-235-8855",
            "fax_number": "717-235-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 WATER ST",
            "city": "GLEN ROCK",
            "state": "PA",
            "postal_code": "173271011",
            "telephone_number": "717-235-8855",
            "fax_number": "717-235-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN YORK COUNTY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-235-8855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007378L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "SO1351319",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.