Individual provider Active NPI

Adham Hanna Abdallah, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1952585291
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7884 Issued in AZ
Practice address
1855 W Greenway Rd
Suite 111
Phoenix, AZ 85023-3475
Phone
(602) 993-0131
Fax
(602) 993-7335
NPI assigned
Dec 21, 2007
Last updated
Oct 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7884 AZ Primary

Addresses

Primary practice location

1855 W Greenway Rd
Suite 111
Phoenix, AZ 85023-3475

Mailing address

1800 S Milton Rd
Ste 14
Flagstaff, AZ 86001-6336
Phone (602) 993-0131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080528000046 AZ Practitioner - Chiropractic 5294805685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1800 S Milton Rd
Suite 14
Flagstaff, AZ 86001-6336
Phone (928) 774-0026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7884AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Joint LLC Chiropractor CurrentSince Apr 7, 2017 Accepting new patients
Nelson Life Centers Chiropractor Past Accepting new patients

Locations

1800 S Milton Rd
Ste 14
Flagstaff, AZ 86001
Phone (928) 774-0026

1855 W Greenway Rd
Ste 111
Phoenix, AZ 85023
Phone (602) 993-0131

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1952585291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 S MILTON RD",
            "address_2": "STE 14",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860016336",
            "telephone_number": "602-993-0131",
            "fax_number": "602-993-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 W GREENWAY RD",
            "address_2": "SUITE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850233475",
            "telephone_number": "602-993-0131",
            "fax_number": "602-993-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLAH",
        "first_name": "ADHAM",
        "middle_name": "HANNA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-21",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.