Organization Active NPI

Stand Up Chiropractic

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1912461336
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
STAND UP CHIROPRACTIC
Practice address
814 Morena Blvd Ste 306
San Diego, CA 92110-2626
Phone
(619) 500-7787
NPI assigned
Jan 30, 2019
Last updated
Mar 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Ryan BergNPI 1295217941
Title
Owner
Phone
(619) 500-7787

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
Chiropractor 111N00000X Primary

Addresses

Primary practice location

814 Morena Blvd Ste 306
San Diego, CA 92110-2626

Mailing address

814 Morena Blvd Ste 306
San Diego, CA 92110-2626
Phone (619) 500-7787

Other names 1

  • Stand Up Chiropractic Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191112002062 CA Part B Supplier - Clinic/Group Practice 1951733013 Receives reassigned benefits from 2 practitioners
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

814 Morena Blvd
Ste 306
San Diego, CA 92110
Phone (619) 500-7787

Practitioners & affiliated clinicians

Practitioners 2

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": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1912461336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 MORENA BLVD STE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102626",
            "telephone_number": "619-500-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 MORENA BLVD STE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102626",
            "telephone_number": "619-500-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAND UP CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-500-7787"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stand Up Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.