Community Chiropractic Clinic, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08001591A Issued in IN

Legal business name

COMMUNITY CHIROPRACTIC CLINIC, PC

Practice address

8000 Calumet Ave
Munster, IN 46321-1227

Phone

(219) 836-2580

Fax

(219) 836-9366

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jose Cordova, DC

Title

Owner Doctor

Phone

(219) 836-2580

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1952496275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 CALUMET AVENUE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211218",
            "telephone_number": "219-836-2580",
            "fax_number": "219-836-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211227",
            "telephone_number": "219-836-2580",
            "fax_number": "219-836-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CHIROPRACTIC CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "CORDOVA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "219-836-2580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001591A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100147700A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Munster, IN
• Providers in Munster, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.