Organization Active NPI

Pelloquin Chiropractic, LLC

  • Chiropractor
  • Scott, LA
National Provider Identifier
1942432331
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1503 Issued in LA
Legal business name
PELLOQUIN CHIROPRACTIC, LLC
Practice address
1606A Saint Mary St
Scott, LA 70583-5157
Phone
(337) 298-0154
Fax
(337) 432-5467
NPI assigned
Aug 18, 2009
Last updated
Aug 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Authorized official

Name
Dr. Dustin Pelloquin, D.C.NPI 1851534382
Title
Owner
Phone
(337) 298-0154

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 1503 LA Primary

Addresses

Primary practice location

1606A Saint Mary St
Scott, LA 70583-5157

Mailing address

1606A Saint Mary St
Scott, LA 70583-5157

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091007000802 LA Part B Supplier - Clinic/Group Practice 8527104389 Receives reassigned benefits from 3 practitioners
Practice locations: Scott, LA

National Provider Directory

National Provider Directory

Locations

101 Park West Dr
#A
Scott, LA 70583
Phone (337) 504-4882

1606 Saint Mary St
#A
Scott, LA 70583
Phone (337) 504-4882

1606A Saint Mary St
Scott, LA 70583
Phone (337) 298-0154

Practitioners & affiliated clinicians

Practitioners 5

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": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1942432331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606A SAINT MARY ST",
            "city": "SCOTT",
            "state": "LA",
            "postal_code": "705835157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606A SAINT MARY ST",
            "city": "SCOTT",
            "state": "LA",
            "postal_code": "705835157",
            "telephone_number": "337-298-0154",
            "fax_number": "337-432-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLOQUIN CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "PELLOQUIN",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-298-0154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.