NPIMap

Organization Active NPI

Chiropractic Injury Center, LLC

  • Chiropractor
  • Revere, MA
National Provider Identifier
1932264900
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2403 Issued in MA
Legal business name
CHIROPRACTIC INJURY CENTER, LLC
Practice address
199 Shirley Ave
Revere, MA 02151-3258
Phone
(781) 485-3801
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeffrey I Keller, D.C.NPI 1144385196
Title
Dr. Jeffrey Keller
Phone
(781) 485-3801

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2403 MA Primary

Addresses

Primary practice location

199 Shirley Ave
Revere, MA 02151-3258

Mailing address

199 Shirley Ave
Revere, MA 02151-3258

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932264900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 SHIRLEY AVE",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 SHIRLEY AVE",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513258",
            "telephone_number": "781-485-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC INJURY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DR. JEFFREY KELLER",
        "authorized_official_telephone_number": "781-485-3801",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.