NPIMap

Organization Active NPI

Charonis Chiropractic Corporation

  • Chiropractor
  • San Carlos, CA
National Provider Identifier
1902082902
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27902 Issued in CA
Legal business name
CHARONIS CHIROPRACTIC CORPORATION
Practice address
1682 Laurel St
Suite a
San Carlos, CA 94070-5217
Phone
(650) 631-1500
Fax
(650) 631-1504
NPI assigned
Jan 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Angelo Charonis, DCNPI 1407943251
Title
President
Phone
(650) 631-1500

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
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC27902 CA Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A91713 CA

Addresses

Primary practice location

1682 Laurel St
Suite a
San Carlos, CA 94070-5217

Mailing address

1682 Laurel St
Suite a
San Carlos, CA 94070-5217
Phone (650) 631-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101203000342 CA Part B Supplier - Clinic/Group Practice 2062609019 Receives reassigned benefits from 1 practitioner
Practice locations: San Carlos, CA

National Provider Directory

National Provider Directory

Locations

130 Shoreline Dr
Ste 130
Redwood City, CA 94065
Phone (650) 631-1500

1682 Laurel St
Ste A
San Carlos, CA 94070
Phone (650) 631-1500

Practitioners & affiliated clinicians

Practitioners 6

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": "1200873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1902082902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1682 LAUREL ST",
            "address_2": "SUITE A",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705217",
            "telephone_number": "650-631-1500",
            "fax_number": "650-631-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1682 LAUREL ST",
            "address_2": "SUITE A",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705217",
            "telephone_number": "650-631-1500",
            "fax_number": "650-631-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARONIS CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-21",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "CHARONIS",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-631-1500",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27902",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A91713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.