Organization Active NPI

Ironwood Chiropractic PLLC

  • Chiropractor
  • San Tan Valley, AZ
National Provider Identifier
1902294614
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7506 Issued in AZ
Legal business name
IRONWOOD CHIROPRACTIC PLLC
Practice address
85 W Combs Rd Ste 109
San Tan Valley, AZ 85140-9107
Phone
(480) 882-9105
Fax
(480) 458-5833
NPI assigned
Jan 5, 2015
Last updated
Apr 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Christopher Ray Butler, D.C.NPI 1851401772
Title
President
Phone
(480) 433-8294

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
Chiropractor 111N00000X 7506 AZ Primary
Physical Therapist 225100000X 7506 AZ

Addresses

Primary practice location

85 W Combs Rd Ste 109
San Tan Valley, AZ 85140-9107

Mailing address

85 W Combs Rd Ste 109
San Tan Valley, AZ 85140-9107
Phone (480) 882-9105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150421001978 AZ Part B Supplier - Clinic/Group Practice 5890013940 Receives reassigned benefits from 3 practitioners
Practice locations: San Tan Valley, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1902294614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W COMBS RD STE 109",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851409107",
            "telephone_number": "480-882-9105",
            "fax_number": "480-458-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 W COMBS RD STE 109",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851409107",
            "telephone_number": "480-882-9105",
            "fax_number": "480-458-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRONWOOD CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-433-8294",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7506",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.