NPIMap

Organization Active NPI

Source Chiropractic & Rehabilitation, LLC

  • Medical Specialty Clinic/Center
  • Metairie, LA
National Provider Identifier
1942453329
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
1364 Issued in LA
Legal business name
SOURCE CHIROPRACTIC & REHABILITATION, LLC
Practice address
4033 Veterans Memorial Blvd
Suite D
Metairie, LA 70002-5525
Phone
(504) 324-5617
Fax
(504) 324-5618
NPI assigned
Oct 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Authorized official

Name
Dr. David Christopher Edwards, D.C., C.C.S.P.NPI 1083750400
Title
Owner
Phone
(504) 324-5617

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
Medical Specialty Clinic/Center 261QM2500X 1364 LA Primary

Addresses

Primary practice location

4033 Veterans Memorial Blvd
Suite D
Metairie, LA 70002-5525

Mailing address

4033 Veterans Memorial Blvd
Suite D
Metairie, LA 70002-5525
Phone (504) 324-5617

National Provider Directory

National Provider Directory

Locations

4033 Veterans Memorial Blvd
Ste D
Metairie, LA 70002
Phone (504) 324-5617

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": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1942453329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 VETERANS MEMORIAL BLVD",
            "address_2": "SUITE D",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700025525",
            "telephone_number": "504-324-5617",
            "fax_number": "504-324-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 VETERANS MEMORIAL BLVD",
            "address_2": "SUITE D",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700025525",
            "telephone_number": "504-324-5617",
            "fax_number": "504-324-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE CHIROPRACTIC & REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-324-5617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., C.C.S.P."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "LA",
            "license": "1364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.